The COVID-19 pandemic has 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. What’s more, you should know what to do in case you make a mistake while providing patient care.
This article first explains the most common types of nursing mistakes. It then provides steps you can take if you inadvertently make a mistake on the job. We base these suggestions on an examination of publicly available hospital reports from the Centers for Disease Control and Prevention (CDC), National Institutes of Health (NIH), the U.S. Department of Health and Human Services’ Office of Disease Prevention and Health Promotion (ODPHP), and Medicare.
Mistake #1: Preventable Infections
According to the CDC, about one in 25 U.S. hospital patients each year is affected by a healthcare - associated infection (HAI). Nurses play a key role in preventing HAIs and improving patient care standards. Practicing standard precautions when providing first aid or healthcare can help prevent the transmission of bloodborne pathogens, for example.
COVID-19 surges were associated with increased HAI rates within hospitals, according to research published May 2022 in Clinical Infectious Diseases. The study showed increases in a number of HAIs used to measure hospital performance, including central line - associated bloodstream infections (CLABSI), catheter - associated urinary tract infections (CAUTI), and methicillin - resistant Staphylococcus aureus (MRSA) bacteremia. Increased rates of hospital - onset bloodstream infections and multidrug resistant organisms, including vancomycin - resistant enterococcus, MRSA, and Gram - negative organisms, each occurred with COVID-19 surges.
Mistake #2: Improper Documentation
When patients’ information is recorded incompletely or incorrectly, the care needed may not happen. Types of documentation errors include not recording (or recording inaccurate details about):
- Patient histories
- Medications given or stopped
- Nursing actions
- Instructions for care going forward
“[A documentation] error can create a ripple effect,” explains 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 says.
Still, mistakes happen. Each year in the U.S., as many as 9,000 people die due to medication errors. Hundreds of thousands more suffer from complications.
Michael Villeneuve knows this firsthand. 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 to 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, that he was going to lose his license, and that the patient was going to die.
Fortunately, the patient recovered. Villeneuve went on to head the Canadian Nurses Association, where he educated nurses on safety before his retirement in March 2022.
Mistake #4: Disregarding Risk Management Procedures
“There are Safety Officers whose entire purpose in life is to deal with issues relating to safety,” says Nick Jacobs, senior partner at Senior Management Resources in Pittsburgh and founder of the Clinical and Translational Genome Research Institute. “Safety education is an ongoing part of any facility.”
The safety guidelines set by hospitals and other settings in which nursing care is provided help nurses identify risks and minimize the chance of mishaps occurring. They also outline the steps to take when an incident occurs. When these protocols are not followed, nursing mistakes are more likely to result.
Mistake #5: Patient Falls
Between 700,000 and 1,000,000 people fall each year in hospitals, according to the Agency for Healthcare Research and Quality (AHRQ). Research shows that patient falls are the most common adverse events reported in hospitals, and that patient falls in hospitals result in about 250,000 injuries and up to 11,000 deaths annually. Nearly one - third of these falls are preventable.
While most nurses do their best to prevent falls, they still occur. A number of factors can increase the risk of falls, including problems with walking and transfers, medication side effects, confusion, and frequent toileting needs. Failure to check on patients regularly, not accompanying those who need mobility assistance, or forgetting to put items patients may need close by can also increase the risk for hospital falls.
Mistake #6: Task Overload
Nurses are expected to handle multiple patients and tasks simultaneously. Such an overwhelming workload can lead to inadvertently skipping vital tasks, such as documenting when a patient took medication so the rest of the team knows not to administer it.
“Nurses are the catch - all for every other service the patient comes into contact with,” says Kia.
Many of these tasks time away from valuable patient interaction and documentation — especially if the workplace is dealing with staff shortages.
“The best way to prevent nursing errors is to alleviate the burden of tasks at the bedside,” Kia comments.
Asking colleagues or superiors for help is one important way nurses can respond to having too many simultaneous responsibilities. Others may have tips for managing tricky workloads or prioritizing tasks. If unreasonable workloads prove to be too overwhelming and are negatively affecting patient care, help from managers should be sought out.
Mistake #7: Ignoring Signs of Fatigue and Stress
“Fatigue is a commonly recognized challenge for hospitals and healthcare providers,” says 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 work, feeling resentful and frustrated by the job and/or colleagues, and finding it hard to empathize with 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," shares 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.
Everyone makes mistakes, even nurses. But because nursing mistakes can have particularly dire consequences, it’s incredibly important that you arm yourself with all the information you need 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.
Originally published by Lauren Katulka on July 16, 2018.
Updated by Paul Dughi on September 27, 2021.
Updated by Lynn H. on July 28th, 2022.
Image courtesy of iStock.com/FG Trade