Constantly Making Mistakes

[Blueb, BSN]

Hi everyone,

I’m a new grad of about a year and a half, working as a floor nurse. Since I’ve started I’ve been repeatedly messing up. I’ve never harmed a patient, however, I’ve made 4 med errors now (some of which were purely my fault such as missing a ‘right’ of med administration, to some which were identified systematic errors). I’ve had a few non-med errors and near misses as well.

Each time I’ve felt completely devastated, immediately assessed the patients and informed the necessary people, then self reported. I create a plan to never have the same error occur again, write the plan down and talk to my manager. I truly reflect hard on each mistake and think about what I could have done differently. Luckily my facility has been non-punitive for errors but I just feel like such a huge failure since I keep making them. There are nurses I work with who have had decades-long careers without making as many errors. On the other hand, I’ve seen colleagues make mistakes in the workplace and choose not to report. 

I can see forgiving a new grad making 1 or 2 mistakes, but I just can’t be okay with how many I’ve made. Each one keeps me up at night and gives me horrible anxiety. I am anxious every time I do a med pass. I just want to do well and of course never want to harm anyone, but I’m wondering if these string of errors is cause for me to quit (or be fired). 

Am I alone in this feeling? Have other nurses out there made repeated mistakes like me? Should I just quit being a nurse? 

[JKL33]

Have you identified any common thread in the types of errors you have made? E.g. are you becoming too rushed, distracted, looking without really looking? Is there some aspect of the EMR that trips you up? Not familiar with the medications?

Just ideas. It would be good to understand the circumstances that precede or lead to the errors, not just identifying what should have happened after something has gone wrong (although that is good, too).

No you don't need to quit your job or nursing. It's possible you're even in a bit of a so-called vicious cycle where you make a mistake, anxiety is increased to the point that you are somewhat more likely to make a second mistake, etc. As far as this is concerned maybe it's a matter of "clearing your slate," so-to-speak, so that you can just mentally/emotionally start afresh.

You can work it out if you don't give up. ??

[amoLucia]

I believe we all sympathize with you as I'm sure we've all been there at times.

Have to ask - what type of unit? Could it just be the level of care acuity of the unit that has you twisted up? Maybe shift overload? Something's overwhelming you, and you're wise, astute & concerned to see it and care seriously enough to do something about it. That's a mark of a good nurse, so I want to say hang in there. But ...

What jumps out to me seems that MAYBE you're in the wrong place at the wrong time and need to break the cycle. It's affecting you personally and most seriously, professionally. That's what's disturbing.

Are you eligible for any vacation time? Maybe take some type of clinical course as a refresher to recharge & reset your nsg batteries. Maybe you could consider an interim transfer to a totally different unit  - like to jump start your career all over again.

Could there be something in your personal life that is causing you problems? Underlying distress that's spilling over to your job? Is your health OK? Also, you won't be the only nurse to be facing Covid distress at this time.

You're doing great trying to find the root problem.  PP JKL adds some good ideas that I hope I am supplementing.

Wishing you all the best. Please check back in for some continued support.  

[SansNom]

It's quite possible also that other nurses are making errors that you're not aware of. It hasn't happened often in my 9 years of nursing, but if I make an error that has not harmed or affected my patient at all, I do not beat myself up over it. Some have been minor enough that I don't even report or do anything about them. I'm not sure what kind of errors you've made, but it's not always necessary to report and make a big deal out it. That's not dishonest or sneaky or bad nursing, just fix the problem (if necessary) and move on. Other nurses might even be making big errors that they report and take care of but you never hear about.

Again, I don't know what errors you've made, but it sounds to me like at least one part of the problem is that you're being too hard on yourself.

[FolksBtrippin, BSN, RN]

I make mistakes. I don't report all of them. I only report them if it's necessary to do so. I hardly remember most of them. 

Its also now my job to find mistakes.

I find so many mistakes, every single day.

Transcription errors, documentation errors, administration errors. Lots and lots of them. Every day.

You've made 4 med errors. So what?

Stop counting your med errors. Start counting your saves and wins.

 

 

[Crystal-Wings, LVN]

^ this

[Tibwee, BSN, RN]

I’m 8 months in and I have definitely made lots of mistakes and it definitely brought me down. But what helped me was I kinda had to change my mindset. Think about if you truly harmed anyone at day from that mistake. I see you did the right thing and assessed them so that’s a great thing! At the end of the day they were all just mistakes and you realized it and you tried to fix it. You didn’t purposely try to harm the pt. Maybe think about how to prevent them next time but this is what learning is all about. I work with a lot of seasoned nurses some of them are rude af and don’t remember what it was like to be new but the others have done many mistakes and they tell me about it. Remember nursing is a life learning career! You got this!

[un2gsus, RN, EMT-P]

I am quite sure we all have made mistakes; as long as it does not cause a seminal event.  Like what others are telling you, “slow down, read the orders five times if you have to.  I truly can’t imagine the double check system even allowing you to make mistakes.  You are not alone!  Ask another coworker to check your work until it becomes second nature.  

Some systems scan bar codes on the mobile nursing system, then scan to get the right medicine and amount, then finally scanning the patient’s identity band.

Systems like these can be expensive, but so is a wrongful death or injury.  Now that you have some experience, I would start looking into employment at a large hospital that has the most up to date systems that prevent errors.  Making errors can lead up to getting dismissed with a record.

REMEMBER!
Medicine and nursing is common sense.  If you have time before your shift, take a walk around the unit and at the door look at the patient or patients you might get assigned and memorize them, they are more than a person with an illness, you are there to help them.  I found it better to make 3x5 cards on them.

 I have retired after 40+ years in medicine (Combat Medic, Paramedic, Respiratory Therapist, and Nurse).

[Camillemm]

All nurses make mistakes, we are human.  You recognize when you've made an error so you obviously know what you are doing wrong.  Concentrate on the task at hand, without thinking about what else you need to do.  I have been an RN for nearly 40 years.  The nurse who tells you they haven't made a mistake in decades cannot be telling the truth.  We are human.  And good hospital will not treat a medication error in a punitive way.  They will assess the situation and look for ways error can be avoided in the process.  If an institution treats the nurse who makes a med error in a punitive way it only teaches that nurse not to report the next error.

[NDS RN]

Hi, I wanted to say I understand how you’re feeling since I am in the same situation. I’m making mistakes constantly and I get so anxious and stressed each time  I feel I should quit being a nurse and find another job. I hope by now you feel a little better. When I think back to my mistakes I can’t believe how stupid they are. I look for ways to help myself but the amount guilt and shame I feel is so overwhelming that It makes me afraid of taking on the nursing tasks . Thinking that I’m going to make more mistakes and feelings embarrassed. 
I believe that I hold negative core beliefs about myself and these mistakes making it harder for me to change my behavior. 
I hope you find a way to grow out of this and be successful at your job.

[LibraNurse27, BSN, RN]

6 minutes ago, nazrn said:

Hi, I wanted to say I understand how you’re feeling since I am in the same situation. I’m making mistakes constantly and I get so anxious and stressed each time  I feel I should quit being a nurse and find another job. I hope by now you feel a little better. When I think back to my mistakes I can’t believe how stupid they are. I look for ways to help myself but the amount guilt and shame I feel is so overwhelming that It makes me afraid of taking on the nursing tasks . Thinking that I’m going to make more mistakes and feelings embarrassed. 
I believe that I hold negative core beliefs about myself and these mistakes making it harder for me to change my behavior. 
I hope you find a way to grow out of this and be successful at your job.

I'm sorry you are going through this, and wondering if you have sought some counseling? Confidence is important and very helpful, sometimes going into a task thinking you will succeed helps you succeed... in my humble opinion ? This is something I had to work hard on, but changing negative beliefs about yourself is so beneficial.

[KatiejonD, RN]

“I make mistakes. I don't report all of them. I only report them if it's necessary to do so. I hardly remember most of them. 

Its also now my job to find mistakes.

I find so many mistakes, every single day.

Transcription errors, documentation errors, administration errors. Lots and lots of them. Every day.

You've made 4 med errors. So what?

 Stop counting your med errors. Start counting your saves and wins.”

 

Please do not turn into this type of nurse. This is HOW we hurt or kill our patients. Every error matters because it is someone’s life entrusted to our care. Do not brush them off, do not cowardly choose not to report (and learn from) them. Care deeply about them. It will help you improve, I promise. Don’t beat yourself up about them, and don’t sink into feeling horrible and depressed about them... but you should never stop caring. Nursing has long been considered the most trusted profession, but that is changing because of nurses who think and conduct themselves as above. Slow down in your administration of meds, make certain that you complete your “rights”, and you will grow as a nurse - then become the example to your colleagues. It is wrong (simply put) to do what this nurse admits she does. I don’t know who needs to hear it - but it is wrong, and it is not OK.