Is being worried about making a mistake normal?

Nascar nurse, ASN, RN · Mar 2, 2012

I think it's a very healthy worry. This will help to keep you from killing somebody. The students - grads - experienced nurses that think they are incapable of making a mistake scare the crap out of me!

Meriwhen, ASN, BSN, MSN, RN · Mar 2, 2012

Some anxiety over making mistakes is normal and in fact a good thing, since it will keep you on your toes. When the anxiety becomes severe enough to paralyze your performance and you start losing sleep over the mistakes you haven't made yet, then it's not a good thing.

The key is to keep the anxiety at a reasonable level.

PeepnBiscuitsRN · Mar 2, 2012

If you didn't give it another thought I'd be worried. As for air in the line or not opening the roller clamp:

-If the clamp isn't open, usually our pumps (the little Baxter ones) will start beeping almost instantly...and won't shut up until you remedy the situation.

- It will also beep if there is air in the line. While air in the line isn't good, I've been told that it would take nearly a whole line of air to hurt someone...of course if they have a central line that's not good period. Always check below the pump for air- I usually do that anyhow, just trying to keep my tubing straight if they have several sets of tubing and are saline locked, trying to see which line goes to which.

As for how a patient will react to something, if it's their first or second time getting the medication, the unfortunate deal is, you don't know. Unless they had a bad reaction to something in the medication family (like the idea that if someone has an allergic reaction to a cephalosporin, they'll often have problems with the penicillin's too). It's more being ready and knowing what to do IF it happens, as opposed to WHAT IF. If you follow guidelines when pushing, then you're doing no wrong unless you already know that your patient needs to have something pushed slower than recommended (Unless it's adenosine, in which case you've got other cares to concern thyself with).

healthproRN · Mar 2, 2012

I agree with the above posts. It is always a good sign when there is a healthy amount of anxiety in the beginning. That should taper, but the concern should not. It just shows you are very focused on quality nursing and the safety of your patients. Definitely when it interferes with your sleep pattern and/or your ability to perform on the job, that would be a cause for concern. Medication errors tend to be the most common of errors, especially among students and newly licensed RNs. Some places have, as policy, the need for meds to be double or even tripled checked, e.g., when they are withdrawn from the patient's med profile and prior to giving them to the patient at bedside.

With regard to how fast to push meds or setting drip rates, definitely always follow the guidelines for that specific med. For example, you should not push Lasix too fast to avoid any ototoxicity. For me, as a rule of thumb, I try not to push IV meds or even saline flushes, too fast through IVs on an elderly patient. Getting a new line can be difficult because their veins are challenging to access. And when you flush or push meds, their veins are fragile so you want to avoid any painful events. Some meds are going to sting, like Postassium, so ask your preceptor about infusing it with saline concurrently to avoid a painful infusion as opposed to piggyback. And I agree that most IV pumps will beep when there is any type of occlusion in the tubing. A few bubbles in the line will not cause any safety issues, so do not worry. Definitely prime the tubing as best as you can though. Aim for no bubbles at all! And above all, remember to be kind to yourself! Beating yourself up for mistakes you have made does not help you or the patients you care for. We all make mistakes, and you will make them. Just make sure you allow yourself to make them, and most importantly, learn from them to avoid them in the future.

Best of luck!

Been there,done that, ASN, RN · Mar 2, 2012

Your concern appears excessive.

This could be an OCD.. please discuss it with a mental health professional.

noahsmama · Mar 2, 2012

Your concern appears excessive.
This could be an OCD.. please discuss it with a mental health professional.

If this is a joke, it's not funny.

And if it's not a joke, I'm going to have to respectfully disagree.

nurseprnRN, BSN, RN · Mar 2, 2012

i think that beenthere could have a point. some concern in novices is healthy (and we really worry about the ones that don't have any:uhoh3:), and if it's excessive enough that you're worried enough to ask here, it probably wouldn't hurt to ask a professional who's closer to where you live.

what's to lose? anxieties tends to accrete like icicles until they're big enough to do real damage. nip this one in the bud. got a school health department? that's your first step, and you will not be the first person they've seen with this. wish_me_luck, you don't need to be embarrassed to ask for a little advice on managing this, that's precisely why they are there.

let us know what happens.

Been there,done that, ASN, RN · Mar 3, 2012

If this is a joke, it's not funny.
And if it's not a joke, I'm going to have to respectfully disagree.

I certainly was not joking. OP was describing repetitive behaviors and asked if she should consider assistance for her anxiety.

I have many years of psychiatric experience and I recognized an issue that I felt needed to be evaluated by a professional.

rockstar11 · Mar 3, 2012

I'm a new grad and double- or triple-check my actions. It's going to take a while before everything is routine and second nature, and I don't want to make any huge mistakes or kill someone.

The anxiety can drive me nuts at times. And I know that I have to work to control it. But I'm certainly not going to be labeled as diseased for double or triple checking something if I don't understand it. Nurses have to be meticulous with safety... new or seasoned.

MN-Nurse, ASN, RN · Mar 3, 2012

I am just not sure if this is normal, being a student, or if this is a personal anxiety issue that I need to get something for. I am very type A personality though. So, what are your thoughts?

As a student, you absolutely should worry about all those things. As you gain experience, you still worry about all of them, but the process is much smoother and less consuming. For instance you will triple check a med you are familiar with in about 1/10th of the time it takes you now. You are still doing all the same checks.

If, as you gain experience, your anxiety about these things doesn't fade, then you have a problem.