Anxiety over making mistakes?

Published

Hi Allnurses

It might be just me, but I recently feel so anxious over making a mistake.

I wI recently felt so anxious over the job that I am doing.

I am not a multitasker and I am quite forgetful when I receive too much information.

I try not to make a mistake and have not made one so far, but I just can't stop thinking about making a mistake and accidentally harming patients.

I want to quit bedside nursing due to my anxiety....

What should I do?

Up Vote Up Vote ×
Specializes in Mental Health, Gerontology, Palliative.

Hi

Anxiety sucks. And it sucks even more when a mistake is made. I know for myself I can totally tie myself up in knots about all the 'shuda coulda wouldas' that should be happening. 

Advice? Look at your mistake. What happened? What could have contributed to the mistake? What have you learned from the mistake? What will you do in the future to make sure it doesnt happen again. The Gibbs model of reflection is a good framework to use. 

I used it recently when I forgot a patients lunchtime morphine dose.  I was able to identify that things get busy and its really easy to miss things if its not directly in my eye sight. So one of the things I did after I'd given the breakfast dose was to leave the controlled drug book open to this patients page out on the counter in my med room as a visual prompt to remind me at lunchtime. 

You mentioned you are not a multitasker and find it overwhelming with large amounts of information, its time perhaps to consider becoming a list person. When I have an acute assignment (4/5 patients instead of the 20 plus in LTC) I take an A4 piece of paper and divide it up into however many patients I have and then across the top mark 0700 0800 0900 1000 etc. Helps me to plan out my day and also if I give a PRN at a certain time I make a note so when it comes time to write my handover I have all that information easy to access. 

Most importantly, all nurses make mistakes. It's what you do afterwards that matters. If you take it as an opportunity to learn from it and grow in your nursing practice most reasonable employers should not have a problem with that. 

Beating yourself up is not helpful. When I found out about my med error I had a moment of 'dag nab it, how could I be such a dork" and then almost as quickly moved over into "well the mistake is made, how do I learn from this and ensure I don't make the mistake again"

Arohanui Mai❤️

3
Up Vote Up Vote ×
Specializes in Neurosciences, stepdown, acute rehab, LTC.

Thats quite normal, even my most competent new grads say that in different ways. I just did a project on new grad orientations (im gleaning that youre within a year?) And giving people too much information is a big no no. I always try to drill in very foundational measures to prevent infections, falls, med errors, pressure ulcers etc. Meanwhile, I add more complicated information one set at a time. And by complicated I mean the bare minimum on how to safely implement the information. Like, signs of increased ICP, reportable conditions, what to do in common scenarios. Just enough to keep you safe. When s* hits the fan hopefully youre on autopilot with the basics and can focus on your toughest situations, including independent study and turning to experienced people. Also, embarrassing mistakes will happen. Vent it out to someone and come up with a future plan for that. 

Up Vote Up Vote ×

Anxiety, as others have posted, is normal but when it begins to interfere with your day to day life as it sounds like it has for you it may be time to seek support from a therapist or other mental health professional.

I have dealt with depression and anxiety for decades. It absolutely will impact your present and future if not managed. I have learned that the hard way.

Take care.

3
Up Vote Up Vote ×

I agree, counseling can help. IMHO: You can also talk to your doctor. I had bad anxiety years 1 and 2. I talked to my doctor and she ordered a beta blocker PRN for me because she and I didn't want an antianxiety med. I medically qualified and it worked for me at half dose most of the time. But I think talking about the stressors causing anx is necessary for mental health. ? I'm glad mental health is becoming more mainstream. 

Up Vote Up Vote ×
Specializes in New Critical care NP, Critical care, Med-surg, LTC.
On 8/20/2021 at 2:03 AM, pecantreechipmunk said:

I try not to make a mistake and have not made one so far, but I just can't stop thinking about making a mistake and accidentally harming patients.

It's not really a secret, some day you will make a mistake. It's going to happen. It's happened to every single person that's a nurse. Guaranteed. Some are big and some are small, but that's life. If your anxiety over the eventual mistake that you will make become crippling to your ability to do your job, or live your life normally, then you need to find some way to deal with it that's less detrimental to your mental health. 

For most of us in nursing, organization is the key. You got a couple good examples above about how people have structured their job and activities to alleviate some stress by writing things out. The thing is you also have to balance efficiency. You can't spend the first hour of a shift writing out everything you need to do in order to keep them straight.

Give yourself credit for the things you've been able to accomplish so far, and for having good enough insight into your weaknesses. Identifying that you're not a multitasker and you have difficulty with large amounts of information is a very good sign. Because you know that about yourself you can better deal with the issue. Try to find organization strategies that will help you feel better about your upcoming shift. Good luck, you'll be okay!

1
Up Vote Up Vote ×
Specializes in Geriatrics.

Anxiety brews when one focuses too much on the details instead of the big picture. There are many things one can do in nursing that isn’t textbook but it isn’t wrong. Was the patient harmed? Probably not. 
focus on concepts and not specifics for each pt. Just like when someone has low oxygen and you put them on O2 and raise the head of the bed. Your not going to go over the exact pathophysiology in your mind, just help them breathe easier.

Up Vote Up Vote ×

I've been researching depression, anx and other probs and I'm more convinced than ever that we all need to give our brains more priority. Visiting a doctor IMO is first and foremost when experiencing symptoms. I'm trying out the fisherwallace device right now and further refreshing and researching the science behind it. I thought someone here may like this info. If not, that's OK. ?

The use of the below imaging to show how the brain has a pattern with brain/mental illnesses is very interesting: 

https://scholarworks.clarksoncollege.edu/bitstream/handle/20.500.12266/59/neuroimaging the psychologically disturbed brain k. schuett.pdf?sequence=1&isAllowed=y

https://www.withheartproject.com/post/2018/05/05/stop-the-stigma

Notice the frontal cortex of the depressed brain. Look at the activity of the anxious brain. PTSD & Bipolar.  

I think it's important that we know how our experiences affect our brain health. Emotions can restructure the brain on the one hand and, on the other hand, be a result of an existing brain structure. We need to learn to recognize symptoms and understand their importance on an individual basis and as part of a family and society. There should be no stigma with seeking healthcare for the brain health (and it's corresponding symptoms) anymore than for the heart. Protect your brain. Oh, and protect yourself from covid because it can attack the brain.  

 

 

Up Vote Up Vote ×
Specializes in Primary Care, Military.
On 8/27/2021 at 6:59 PM, AtomicNurse said:

I've been researching depression, anx and other probs and I'm more convinced than ever that we all need to give our brains more priority. Visiting a doctor IMO is first and foremost when experiencing symptoms. I'm trying out the fisherwallace device right now and further refreshing and researching the science behind it. I thought someone here may like this info. If not, that's OK. ?

The use of the below imaging to show how the brain has a pattern with brain/mental illnesses is very interesting: 

https://scholarworks.clarksoncollege.edu/bitstream/handle/20.500.12266/59/neuroimaging the psychologically disturbed brain k. schuett.pdf?sequence=1&isAllowed=y

https://www.withheartproject.com/post/2018/05/05/stop-the-stigma

Notice the frontal cortex of the depressed brain. Look at the activity of the anxious brain. PTSD & Bipolar.  

I think it's important that we know how our experiences affect our brain health. Emotions can restructure the brain on the one hand and, on the other hand, be a result of an existing brain structure. We need to learn to recognize symptoms and understand their importance on an individual basis and as part of a family and society. There should be no stigma with seeking healthcare for the brain health (and it's corresponding symptoms) anymore than for the heart. Protect your brain. Oh, and protect yourself from covid because it can attack the brain.  

 

 

Thank you for sharing this. I saved it to go over in more detail later. It absolutely makes sense. Personally, I noticed a significant change in the sharpness of my memory, my ability to learn, and how I performed in classes prior to and after my deployment to Iraq. For example, I was a rock star in TNCC prior to deployment and was even lined up as "instructor potential" without having critical care/er experience. The plan was to keep the letter indicating instructor potential, deploy, and then return and take the instructor class with the experience I'd gained and begin teaching the course for the military. After a rough deployment, however, many things changed. I went from a rock star in the course to someone who could pass it, but not make instructor potential despite having experience. 

 I noticed the change in how quickly I learned new material and how well I retained it between my BSN courses and my MSN courses. Confidence levels in practice, etc. Research such as this is going to be monumentally important considering the extreme stress that our frontline healthcare workers are experiencing now in this pandemic. When I say I went through a rough deployment, I can expand to share that 80% of our ER staff, all of whom I would rank as rock-solid, hard-working, and dedicated nurses, doctors, and medics ended up requiring behavioral healthcare services. That's just one section of our C.S.H. 

  I also recommend looking into the wealth of research we've accumulated on TBI, brain health, and how it connects to mental and emotional health, as well. So many of our patients are impacted by mental or emotional health conditions, whether it's depression or anxiety, that it's important for all of us to keep up our knowledge and remain open to listening. 

1
Up Vote Up Vote ×
+ Join the Discussion