One year in, yet still making errors -- stupid ones!

Nurses General Nursing

Published

Today I had a PCA pump and totally documented it all wrong. I KNEW how to do this, but just didn't remember. We don't do them much -- I probably haven't had a PCA pump in 4-6 months.

I know I should have asked someone, but didn't. Why didn't I? I have no idea.

Also made another error in which I passed on meds to another floor (in trying to keep my pt. safe by not giving digoxin w/ a low HR,) but the nurse on the other floor wrote me up for it -- why I don't know.

At any rate, I felt so confident a while back -- now I feel as if I'm losing confidence for some reason. Is this a common thing in the 2nd year?

eman45

1 Post

I am a new grad as well and I as well have been making mistakes which I feel are quite dumb. Sometimes I fell confident and then I mess up and my confidence breaks again. I really can't tell you how long it will take you to become competent or feel confident all the time. I am just here to tell you that just keep doing your best and never be afraid to ask questions. You are not alone I sometimes feel the same as you, but we'll get it.

kythe, LPN

261 Posts

Specializes in LPN.

Not to excuse mistakes, but sometimes I think other people make us feel worse for our errors than what it's worth. I've been an LPN for 2 years now so you'd think I have the hang of it (ha!), but just two days ago I made a med error that the patient's family complained about.

They didn't complain just once - they literally yelled at me in the hall in front of several people, they complained to the unit supervisor, the DON, and the patient's case worker. I kept hearing about it throughout the shift from various people, and by the end of the day was wondering why I ever became a nurse because I felt that truly incompetent.

I had given the right medication and right dose, but in the wrong form. I gave the patient a pill they had trouble swallowing instead of the liquid form that was ordered. I know it was my mistake and there is no excuse, but how many times can I say I'm sorry and will read the orders more carefully next time?

I doubt mine was the worst med error ever made, but one would think that it was for how the rest of the shift went. These kinds of things make me wish I worked at the McDonalds down the street, where mistakes are more forgivable.

SweetLemon

213 Posts

Specializes in Psychiatric Nursing.
I am a new grad as well and I as well have been making mistakes which I feel are quite dumb. Sometimes I fell confident and then I mess up and my confidence breaks again. I really can't tell you how long it will take you to become competent or feel confident all the time. I am just here to tell you that just keep doing your best and never be afraid to ask questions. You are not alone I sometimes feel the same as you, but we'll get it.

While I do believe it is possible to feel confident that you are attempting to do the right thing by your patient all the time, Nurses who feel confident in everything they do ALL the time Scare me. :eek:

While they might not be pointing out to you every little thing they do wrong I am sure some of the much more experienced nurses that you are working with still makes mistakes, welcome to being human. First try not to make the same mistake twice and second when you do make a mistake try not to let it get you down. As long as you are learning from what you do wrong it is not a waste of time. Also for whatever its worth the more I focus on the fact that I am messing up and my confidence drops the more mistakes I continue to make. A vicious cycle really, sorry you are having a rough time at the moment but we are all here for you here!

Specializes in Acute care, Community Med, SANE, ASC.

I've been a nurse just short of 3 years but in my opinion mistakes will continue to happen--as someone already said--we are human. All you can do is your best. Try to learn from your mistakes and figure out when mistakes happen. I know this sounds obvious but I realized that when I'm rushing like crazy because I know I'm holding up another department or doc--that's when I make mistakes. Be particularly careful with meds--it's hard to take those meds back once they're given. You said you documented a PCA incorrectly--you're right that it is important to document correctly but I'm more concerned with whether or not the PCA was programmed correctly. Try not to beat yourself up--it says volumes that you care enough to try to figure out how to avoid mistakes. I find this job absolutely impossible to do perfectly--which drives me nuts and makes it hard for me to sleep.

Roy Fokker, BSN, RN

1 Article; 2,011 Posts

Specializes in ER/Trauma.

I'm not a new grad. Here's some of the stuff that I remember from this year alone:

* Pt. came in from nursing home with foley in place. No drainage noted in bag and doc wants a urine analysis. Since we're slammed, I told another nurse (one with FAR more experience than I!) to "flush the cath to see if it's patent and try to get a sample". Then, I walked over to tell the Doc. that since there is no output, I'm planning on flushing the cath to see if it's still patent.

Doc says "yeeeeah, don't do that. Because it'll mess up the urine analysis."

D-uh! I knew that already!! But still... :imbar

Luckily, the nurse I'd requested the favor from knew better :chuckle. Ended up re-cathing the pt.

* Pt. came in with chest pain. Doc wants a CT.

"Will that be with or without PO contrast?", I ask.

Doc blinks at me a couple times and says "Roy, pt. is here for chest pain. It's a CTA of the chest. NO PO contrast but IV contrast! Wake up dude!" :smackingf

* I charted an entire conscious sedation procedure on paper - despite the fact that I was the one who'd gone around the unit showing people how to do the same on the computer 4 months prior! :icon_roll

* Repeat mistake (I've done this probably half a dozen times this year) - forgetting to enter the lot number and expiration date after IM vaccination! :imbar :smackingf

* Forgetting to put the ID tag on the toe before sending the body to the morgue! :eek: And while we are at it - forgetting to call organ donation AND the medical examiner prior to sending the pt. to the morgue!

* Trying to flush a clamped IV and getting frustrated that the "line is not working" :imbar

* Giving a patient opiate/narcotic/sedative medication without asking how they're fixed to go back home (naturally, if pt. is driving, one shouldn't give them these meds unless someone can pick them up!) :banghead:

Heh. Silly (and irritating) mistakes... but mistakes no less!

- Roy

al7139, ASN, RN

618 Posts

Specializes in Emergency.

Hi,

I have been a nurse for 2 years now on a telemetry unit. I can tell you from my experience that I am only human and still make mistakes. There is no such thing as a nurse who doesn't make a mistake sometimes. I only hope two things: 1. That a mistake I make never harms a patient. 2. That any mastake I do make never happens twice.

I could go on and on about boneheaded things I have done as a nurse, and lots of them are "Duhh!" mistakes where if I had been paying attention to what I was doing they never would have happened.

I am lucky that I am on a unit where they believe in teaching and education and counseling rather than just writing you up and being punitive. Obviously if it happens more than once there are serious consequences, but In the main, they do not try to be down on you, just teach you what you should have done, and how to avoid it in the future.

Good luck, you are fine.

Amy

UM Review RN, ASN, RN

1 Article; 5,163 Posts

Specializes in Utilization Management.

If the heart rate on the held dose of dig was

Don't feel bad about the PCA pump. Our hospital policy was to have 2 nurses confirm the settings, which I feel is the safer way to go if you don't use the pump very often.

Gesundheit

8 Posts

There is a GREAT song by Indie Arie called "Slow down baby". When things get really busy and I feel pushed pulled and called from all directions I start humming this song. It helps me slow down, prioritize and focus on one thing at a time.

I hate to tell a patient to go ahead and wet the bed (since I don't have the help or 20 minutes to get them to the BSC) but my pt with SVT or new afib takes priority. Getting the right order, written and faxed and administered correctly takes focus.

And for each mistake we make, it's not just ours, it's the whole team. Something happened in the safety net that allowed you to make a mistake. What was that and how can it be better modified? Your Facility should always be asking that question.

And as long as you learn from your mistake, and store it into your red flag zone of your nursing brain (and feel free to share with new grads!) then you are a good nurse. Never be afraid to ask and if you aren't sure, ask someone else till you get the best answer.

SoundofMusic

1,016 Posts

A big thanks to everyone who replied. You really lifted my morning here, on my day off, where I am going over everything in my mind, over and over. This really helped.

It's the "bonehead" errors that get to me most, as someone here said. But I don't know what else to do -- I am NOT always paying attention 110% of the time. I just don't know how that is possible with all the distractions.

And I try to sort of stay quiet, stay focused, stay out of the fray, but you can also come off as unsociable. I see so many nurses who just seem to socialize all day, I have no idea how THEY stay focused. There are just enough distractions already -- phones, patients, families, loud techs, constant interruptions.

Specializes in Med Surg, Ortho.

I'm a year in nursing now and I'm just now starting to feel the same way. I've been feeling so confident, but within the last few weeks, I just feel so incompetent. I've saved lives, I have pts that tell me what a great nurse I am, but I still feel, here lately, that I just in the "duh" kind of mode. I don't know what this feeling is......I call it the first year blues.

SoundofMusic

1,016 Posts

That's a good description of it -- the Duh Mode. Things I SHOULD know -- yet I boggle it. I have also, too, had many successes.

I wonder if they try to build you up, only to then tear you down. It seems all these managers that were once so friendly and approachable are now just turning entirely nasty. I don't even want to talk to them anymore. They think if they show it to you once, perhaps show you their poster or whatever, that you are supposed to be an expert at it. Well, it takes me learning AT the bedside, perhaps over and over, and I just MAY have to make an error once to really learn it. How is that for a learning style? It's called, being Human.

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