Anxiety about nursing medical errors

SoldierNurse22, BSN, RN · Mar 7, 2014

It's quite common. To a certain extent, that fear is good. It keeps professionals across the medical field alert and attentive to possible problems, specifically in their own practice.

Of course, if it's debilitating, that could pose a problem. There are many, many nurses who deal with similar disabilities on a daily basis, so it isn't impossible, but it takes a great deal of self-awareness I would think to intentionally put yourself in a situation where you'll be facing your anxiety head-on.

Also, please note that you will make mistakes as a professional. They may or may not be fatal, but they will happen. It isn't a matter of maybe but a matter of time. Please read the article below and understand that we are merely human, and even our best attempts aren't always good enough.

https://allnurses.com/general-nursing-discussion/mistakes-inevitable-no-909775.html

Pangea Reunited, ASN, RN · Mar 7, 2014

Everyone makes mistakes, although they're usually not fatal. There are plenty of safeguards in place to help prevent mistakes, but human beings will always find a way around them.

1. Read about and understand any medication you're not familiar with, even if you're in a huge hurry.

2. Pharmacy usually verifies medication and does their own checks before it's available to you (they can miss things too, though)

3. Have another nurse check any high risk medications before administration (most places require this)

4. Many hospitals have scanners that help match a patient with their medication and alert you if the scanned dose is too high, too low, too early, etc.

5. Many hospitals have pixis machines that will only allow you to access medication ordered for that particular patient (but there are usually a few "open" compartments and you can still pull the wrong amount

6. If you're giving half of something, pull out a sharpie and write 1/2 on it as soon as you pull it

7. If the patient is alert and oriented, confirm what they're taking with them as you're preparing it

8. When pharmacy enters medication, a nurse also has to confirm it with the doctor's written order before it can be given

9. Pull medication for only one patient at a time so it's less likely to get "mixed up"

10. If you're feeling rushed/flustered/frustrated, slow down and take a minute to compose yourself. Accuracy is more important than speed 99.9% of the time

There are probably a bunch more things I'm not thinking of, but those are a few things that help make medication administration less dangerous. There are plenty of other ways to harm a patient, as well. It could be something as simple as not noticing a lab result...

Good nurses always worry about their patients and potential mistakes, but too much anxiety can actual make you cloudy-headed and more likely to make an error.

HouTx, BSN, MSN, EdD · Mar 7, 2014

Have you considered pursuing laboratory science or pharmacy instead? Also wonderful health care careers & would be a great fit with your current educational background. Nurses in direct care roles are can't really avoid situations that are associated with risk to the patient because of the unpredictability of dealing directly with humans. There are no real certainties.

NurseSN45696 · Mar 9, 2014

You were given great advice from the other responders. As far as managing your anxiety, does your current or potential school offer any kind of guidance or counseling for students struggling? Have you considered going on a stint of anti-anxiety medication or possibly therapy to learn some cognitive behavioral techniques to help you deal with anxiety?

RNsRWe, ASN, RN · Mar 9, 2014

You really got some GREAT answers here already.

After reading your post, my thought was to type "how do we prevent errors? By going to nursing school, paying attention, learning well, and being careful". Does this prevent ALL errors? Nope.

Most nursing errors aren't fatal, as someone pointed out. Most, actually, are quite minor, and the only ones who find it to be a big deal are the nurses who made the mistakes--and are taking it much harder than they should. As I said, MOST are small, inconsequential mistakes.

And the big ones? Frequently the result of poor policies, poor education, inattention or lack of concern.

I once had an instructor tell me something I have MANY MANY times passed on to students AND new nurses....as well as anyone I came across who was freaking over a tiny mistake:

"Any nurse who tells you she has never made a med error is either lying or too stupid to know the difference". Loved that instructor. The longer one is in nursing, the more time goes by and the more opportunity there is to administer meds, the greater the odds for at some point making an error.

Errors are made, and learned from. Care and concern tend to keep them small.

Ruby Vee, BSN · Mar 9, 2014

Nurses are human, and no human is perfect. Everyone makes mistakes. Surprisingly few mistakes are actually fatal, however.

https://allnurses.com/general-nursing-discussion/mistakes-inevitable-no-909775.html

FutureNurse40 · Mar 17, 2014

OMG this is exactly why I keep chickening out of going to Nursing school. I too have major anxiety and always think about being responsible for other people's lives. Also making a medical error, medications freak me out the most. I have prior education in the Medical field (Medical Assisting) but no experience working as one. I really need to find ways to get this anxiety problem under control, but it's a serious disorder.

ShelbyaStar · Mar 17, 2014

I work as a DSP currently, very similar to CNA but we do pass meds. I'm glad to have that experience before getting into nursing.

Med errors happen. A lot. When do they happen? When people get complacent, in a hurry, etc. Double check and triple check like you're supposed to. My company is cheap haha so we do things the old fashioned way in a binder on paper so we don't have scanners and stuff like that.

I think I will similarly have anxiety over making mistakes, which unfortunately can lead to... more mistakes. So at that point I will probably pursue getting help for it. But overall a little bit of anxiety over it is a good thing because it is essential.

Everybody makes mistakes and the vast majority are not serious. There are protocols in place if there is an error- for example at my job we have a 30-60 minute time frame to give meds and if we forget we need to fill out a med error report and call the nurse to figure out what the best thing to do is as far as giving the med or skipping it. It usually is not a huge deal.