The COVID-19 pandemic changed the way we interact with family, friends, and patients. It has created an extra burden for nurses and other healthcare professionals as treatment is provided. It has added even more stress on top of an already difficult job.
We all strive for perfection, but nurses are humans and make mistakes from time to time. So, if you’ve ever made a mistake on the job, just know you’re not alone.
We examined hospital records from the Centers for Disease Control and Prevention (CDC), National Institutes of Health (NIH), the Office of Disease Prevention and Health Promotion at the U.S. Department of Health and Human Services, and Medicare and put together this list of the most common types of nursing mistakes. At the end of the article, we've also provided suggestions for some steps you can take after you've made a mistake.
Mistake #1: Causing Preventable Infections
According to the CDC, about one in 31 U.S. hospital patients contracts at least one healthcare-associated infection on any given day. Nurses play a key role in increasing or decreasing their patients’ risk of this happening. For example, you could cause a preventable infection if you don't clean your hands regularly during your shift or follow an aseptic technique to prevent the spread of harmful organisms.
“With COVID-19 precautions, mistakes that might have been more prevalent should now be happening much less often,” said Nick Jacobs, senior partner at Senior Management Resources in Pittsburgh and founder of the Clinical and Translational Genome Research Institute. “Hand-washing, proper gloving, and proper masking were sometimes a challenge. With COVID, everyone is trying to protect themselves, and their families.”
Mistake #2: Improper Documentation
If you don’t record all of your patients’ information (or if you record that information incorrectly), you could inadvertently prevent them from receiving the care they need. Types of documentation errors include not recording (or recording inaccurate details about):
- Patient histories
- Medications given or stopped
- Your actions
- Instructions for care going forward
“This error can create a ripple effect,” said Rachel Kia, BSN, RN, CMSRN. “Documenting something incorrectly has large implications for potential errors in ancillary services.”
Mistake #3: Medication Errors
Nursing errors can be made when nurses administer the wrong dose of a medication or inadvertently give a patient someone else's prescription. These medication errors can delay a patient's return to health, make them ill, or—in some cases—even lead to death.
“Good systems force multiple checks when dispensing the medication, verifying it with the order in the system and when administering medication to the patient,” Kia said.
Still, mistakes happen. Each year in the U.S., as many as 9,000 people die due to medication errors, according to the NIH. Hundreds of thousands more suffer from complications.
Michael Villeneuve knows this first-hand. After graduating from nursing school and working in a neurosurgical intensive care unit, Villeneuve gave the wrong medication to a patient. He administered a dose of potassium intended for one patient into another. Villeneuve realized the error immediately and called for help as the patient’s heart went into distress. All he could think about was that his career was over, he was going to lose his license, and the patient was going to die.
Fortunately, the patient recovered. Villeneuve went on to head the Canadian Nurses Association, where he educates nurses on safety.
Mistake #4: Not Following Risk Management Procedures
“There are Safety Officers whose entire purpose in life is to deal with issues relating to safety,” said Jacobs. “Safety education is an ongoing part of any facility.”
These guidelines help you identify risks in your environment and minimize the chance of mishaps occurring. They also outline the steps to take when an incident occurs. If you don’t follow this protocol, you may be more likely to make nursing mistakes.
Mistake #5: Failing to Prevent Patient Falls
Hundreds of thousands of patients fall each year. Thirty to 50% sustain injuries, such as fractures, lacerations, or internal bleeding. Yet, research shows that nearly a third of the falls are preventable.
Falls can happen if you don't regularly check in on your patients, fail to accompany those who need mobility assistance, or forget to put items they need close by. Also, if you seem too busy or unapproachable, your patients may try to do too much in your absence.
Mistake #6: Struggling With Task Overload
As a nurse, you’re expected to handle multiple patients and tasks simultaneously. It can feel overwhelming at times and lead to you inadvertently skipping vital tasks, such as documenting when a patient took medication so the rest of your team knows not to administer it.
“Nurses are the catch-all for every other service the patient comes into contact with,” said Kia.
Many of these tasks time away from valuable patient interaction and documentation — especially if you’re dealing with staff shortages.
“The best way to prevent nursing errors is to alleviate the burden of tasks at the bedside,” Kia said.
If you find yourself struggling with this, ask your colleagues or superiors for help. Have them share their tips for managing tricky workloads, or ask them for help in figuring out which tasks should be prioritized over others. If your workload proves to be too overwhelming, consider talking to your manager about shifting some things off your plate.
Mistake #7: Not Listening to Your Body
“Fatigue is a commonly recognized challenge for hospitals and healthcare providers,” said Jacobs. “Some hospitals utilize creative shift structures such as three 12-hour days and then four days off, but when you’re in a crisis situation with at capacity patient load, life becomes even more challenging.”
With long shifts and irregular schedules, nurses often become tired and stressed, which can increase their risk of making mistakes and even burning out. Nurse burnout symptoms include:
- Emotional Exhaustion: Feeling drained, tired, low, and overwhelmed.
- Alienation From Work: Being cynical and disengaged from your work, feeling resentful and frustrated by your job and/or by your colleagues, and finding it hard to empathize with your patients.
- Reduced Performance: Finding it hard to concentrate or follow through on tasks, making more errors, and feeling listless.
"We are wrapped in the frustration of grief and anger as we struggle on the front lines," said Cherron Taylor, BSN, RN, a critical care nurse.
Many are dealing with trauma and mental health issues, including symptoms of PTSD.
4 Steps to Consider Taking If You Make a Mistake
Some mistakes are more significant than others, but few are so large that you can't find ways to fix them. Here are some constructive and proactive steps you can take if you've made a mistake yourself.
Step #1: Acknowledge your mistake and report it.
Don't try to cover up your error or shift the blame from your shoulders. Instead, take accountability for your actions and make sure to follow any risk management protocols your facility has put in place to handle such incidents.
Step #2: Be proactive about fixing the mistake.
If you make a mistake, try not to get discouraged and give up. Many mistakes are fixable, so check in with your supervisor or manager to see if there’s anything you can do to help out. When possible, try to be part of the solution to the problem.
Step #3: Understand what led to the mistake.
There’s no doubt that your nursing mistake may have had dire effects, and it can feel unbearably difficult to focus on anything else. Once you’ve grappled with these feelings, you will want to find out what you could’ve done differently. No matter how drastic the impact of your mistake, use this opportunity to shift your focus toward improving your nursing skills and helping prevent your peers from making the same kind of mistake.
Step #4: Don't ignore how you’re feeling.
Never bury your feelings. No matter how slight or severe the mistake, give yourself permission to feel the anger and remorse that may follow. Journal about it. Discuss it with others. Remember: You are only human. Process your emotions in a healthy way, so you can move on positively. If you need professional help, get it.
Final Thoughts & Additional Resources
Everyone makes mistakes, even nurses, but as you can see from the mistakes listed above, some can have particularly dire consequences. That’s why it’s incredibly important that you arm yourself with all the information you need in order to avoid making mistakes in the first place. And, in the instance where you do commit an error, it’s even more crucial that you know what steps to take to mitigate its effects.
If you’d like to learn more about risk management and patient safety, make sure to check out these articles:
- The Berxi Guide to Risk Management in Healthcare
- Improving Patient Safety in Nursing: 7 Tips Nurses Can Start Implementing Today
- Charting By Exception: What To Be Aware Of When Taking Shortcuts
- 5-Minute Summary: What Is a HIPAA Violation?
- HIPAA & Social Media: What You Can & Can't Post If You Work in Healthcare
Originally published by Lauren Katulka on July 16, 2018.
Updated by Paul Dughi on September 27, 2021.