When a nurse makes a mistake, it can feel like one of the worst things in the world, especially when a simple mistake can potentially change the trajectory of someone else’s life.  Now, that’s a scary thought, isn’t it? While we really don’t want mistakes to happen, we are human and prone to error. Unfortunately, nursing, in general, is a career that leaves very little room for error and even less leeway when it happens. When a nurse makes a mistake, it’s often the result of multiple factors joining together in a high-stress environment. 

What Can Cause A Nurse To Make A Mistake?

• Multitasking: Let’s face it, as a nurse, you are constantly met with interruptions that pull you in every imaginable direction. One minute, you’re in the middle of a med pass, then a patient calls to go to the restroom, your confused patient jumps out of bed, a family member has to ask you a question, the covering doctor needs to speak to you……..the list can go on forever. The point is it’s easy to get distracted. The constant interruptions nurses face can sometimes lead to misunderstandings and miscommunications, ultimately causing mistakes. 
• Burnout And Stress: The demanding nature of nursing typically consists of long hours and emotional labor. The sheer volume of work that a nurse must accomplish during one shift can seem impossible…often leading to exhaustion and burnout. Imagine trying to take an algebra test while physically and emotionally exhausted. It’s kind of like being a nurse. Why? Because as a nurse, regardless of how drained you are, you must be sharp enough to pass the test at all times…..your patient’s lives depend on it. Many times, a nurse makes a mistake simply out of mental fatigue. 
• Shift Work: Many nurses have to work the night shift at some point in their careers. The irregular sleep patterns and chronic fatigue alone can lead a nurse to make a mistake. 
• High Nurse-to-Patient Ratios: Lately, news outlets have been laden with reports of nurses who’ve made critical errors in environments with over 50 patients. Many nurses on med-surg units and emergency rooms are required to care for 7-10 patients simultaneously. It’s almost impossible to medically manage that many people effectively. When a nurse makes a mistake, it’s often related to not having enough time to spend with their patients, leading to oversights or rushed procedures. 
• Lack of adequate training or resources: While nursing education provides a strong foundation, the rapidly evolving nature of medicine means that continuous learning is necessary. Lack of access to ongoing training or up-to-date resources can leave nurses unprepared for specific situations. 
• Systemic Issues: When a nurse makes a mistake, it’s not always the result of their individual actions but an indicator of broader systemic issues. These can include inadequate staffing, poor workflow design, lack of resources, lack of standardized procedures, and/or insufficient administrative support.

What Are Common Ways That A Nurse Makes A Mistake?

As nurses, we strive for perfection, not just for ourselves but for our patients. However, it’s virtually impossible to be perfect because, at the end of the day, we are still human. What helps is awareness. We can better avoid mistakes if we know what kind of mistakes to watch out for. Here are three of the most common nursing errors. 

Documentation Errors:

Facilities require nurses to document in real-time to prevent these errors as much as possible. Oftentimes, a nurse is so busy during their shift that they end up charting everything at the end of the shift. This can lead to the nurse forgetting to document something important…something that could pop up in the future. Here are some ways to help you keep up with your documentation:

• Sticky Notes: I used to keep a bunch of sticky notes on the back of my badge to jot things down as I worked. Some nurses also prefer to carry a small notepad in their pocket. 
• Critical Events: If this occurs, address it immediately and document it in real-time. 
• Timing: Write down the times of your interventions because chances are you won’t remember when back charting. 

Medication Errors

Typically, hospitals will put up several stops such as pharmacy approval, scanning, double verifying critical meds with a second nurse, and utilizing the ‘5 rights’. Still, medical errors happen frequently. Why? Sometimes, in the midst of a busy shift, a nurse will be tempted to pull everyone’s meds at once, increasing the risk of errors. Computers and scanners tend to malfunction, or medication barcodes don’t always scan properly, increasing the risk of errors. There have also been instances where the provider will order a medication for the wrong patient, and the nurse will give it without questioning the order, making them liable for the error. A nurse can avoid medication errors by:

• Confirming the patient’s allergies before administering the medication
• Make sure the medication is appropriate for the patient’s current clinical condition. For example, just because a hypotensive patient takes hydralazine every night at home doesn’t mean you should give it to them. 
• Don’t override any medications without getting another nurse to look at them with you so you can cover yourself. 
• Many drugs are based on your patient’s height and weight. Make sure those are accurate and updated in the chart.
• When in doubt, call the pharmacy! Never administer a med that you aren’t sure about. 

Falls

Oftentimes, confused, delirious, impulsive, or demented patients will continuously try to get out of bed regardless of how many times you try to stop them. Even after administering PRN medications, updating the provider, and utilizing a 1:1 sitter, it can still seem impossible to keep a patient from jumping out of bed and harming themselves.

Because of this, it’s important to remember to do everything within your ability to show that you attempted to prevent the fall. For example, remembering to turn on the bed alarms, keeping the room free of clutter, and documenting your hourly rounds will protect you in the event that a patient falls. If this isn’t done, the blame will automatically fall on your shoulders as the primary caretaker. Therefore, remember to do this because it will ultimately protect you and your license. 

What Happens When A Nurse Makes A Mistake? 

Depending on the severity of the error, the consequences can be far-reaching and debilitating. When a nurse makes a mistake, it can affect the patient, hospital operations, and the nurse’s personal, psychological, and professional life. However, when a nurse makes a mistake, the actual consequences can vary greatly depending on the nature of the error, the circumstances, and how it’s managed. 

Immediate Patient-Care Implications: The most direct consequence of a nursing error is its impact on the patient. This can range from minor, non-harmful incidents to severe cases that might result in patient injury or, in worst-case scenarios, death. The gravity of the error usually indicates how intense of a response is needed. 

Professional and Legal Repercussions: Nurses might face professional repercussions depending on the severity and nature of the error. These can include formal warnings, mandatory retraining, or even suspension. In cases of severe negligence or repeated errors, the possibility of termination or legal action, including lawsuits or loss of nursing licensure, is real. 

Institutional Responses: Healthcare institutions typically have protocols to address the situation when a nurse makes a mistake. This usually starts with an internal investigation to understand the root cause of the error. The goal is to address the specific incident and identify and rectify systemic issues that might have contributed to the error. 

Emotional And Psychological Impact: We can’t underestimate the emotional toll that occurs when a nurse makes a mistake. The guilt, anxiety, and loss of confidence can be overwhelming. The mental burden can exacerbate stress and burnout, further impacting the nurse’s ability to perform well at work.

Public and Patient Perception: When a nurse makes a mistake, it can affect the public’s trust in healthcare institutions. Transparent handling of errors, including clear communication with patients and their families, is necessary to maintain a sense of trust and confidence in healthcare. 

What Should A Nurse Do If They’ve Made A Mistake?

When a nurse makes a mistake, acting promptly and responsibly is crucial. Yes, it’s scary and intimidating, mainly because there is a very real and legitimate fear of retaliation. But acting immediately can increase the chances of preventing further damage. 

• Immediate Action and Assessment: The first step is to assess the situation and take any immediate action required to ensure patient safety. If the mistake can potentially harm the patient, the nurse must act quickly to mitigate the impact, which may involve administering a corrective treatment or alerting a physician.

• Reporting the Error: Transparency is key. The nurse should report the error to the appropriate supervisor or through the healthcare facility’s incident reporting system as soon as possible. Prompt reporting is an ethical obligation critical for institutional accountability and patient safety.

• Documentation: When a nurse makes a mistake, accurate and thorough documentation of the incident is essential. This should include the specifics of the mistake, the context in which it occurred, actions taken to rectify it, and any patient outcomes. Proper documentation aids in the investigation and understanding of the error.

• Collaboration in Investigation: Nurses should be prepared to collaborate in any investigation into the error. When a nurse makes a mistake, they will have to get involved in the investigation by providing further information, participating in interviews, or engaging in a root cause analysis. Nurses working at unionized hospitals are at an advantage because a union representative can assist with the investigation. Honest and constructive participation is vital for understanding the broader context and preventing future errors.

• Reflect and Learn: Reflecting on the error is necessary and helpful for professional growth. Take time to understand what went wrong and why. This reflection can be facilitated through discussions with mentors, participation in debriefing sessions, or personal contemplation.

• Seek Support: Errors can be emotionally taxing, and it’s easy to beat yourself up. So seeking support from colleagues, mentors, or mental health professionals is important when a nurse makes a mistake. Peer support groups within the healthcare facility can also be a valuable resource.

• Engage in Educational Opportunities: If the error highlighted a gap in knowledge or skills, engaging in additional training or education can be beneficial. Many healthcare institutions offer training programs or resources to help nurses improve their competencies. When a nurse makes a mistake, seeking remediation will help rebuild trust within the workplace. 

How Do I Overcome Nursing Mistakes?

Forgive yourself. Nursing is a demanding profession, and errors happen. The only difference is that we are not given the same grace as other professions because of the high-stakes environment. Practice self-compassion and recognize that if you make a mistake, it does not diminish your value as a nurse. The best thing you can do is learn from your mistakes and do your best not to repeat them. Overcoming mistakes is about addressing the error and nurturing your resilience, competence, and confidence as a nurse. When a nurse makes a mistake, it is an opportunity to learn, grow, and become a more skilled and empathetic caregiver.