Feeling terrible about a mistake I made in clinical

[CatieK, BSN, RN]

Hi there, senior nursing student here. The other day I had my first day of clinical in the PICU and I made a completely stupid and dangerous mistake. My poor patient was on numerous drips and have numerous IVs in her right arm. One of the IVs went bad over night shift, and another went bad soon after we completed our morning assessment. She really needed another IV and she was a very hard stick. After about 30 minutes of trying, the vascular access team finally got an IV on her.

Shortly after, we get busy by the doctors rounding, linen changes, trach suctioning, etc. The nurse then asks me if I can take out the IV that had gone bad upon our morning assessment. So I go ahead and take out the IV. It was the WRONG IV. I accidentally took out the brand new IV that they had just placed! Now the two IVs were very close to each other, both on the right forearm. However I still should have which was which considering I had watched them place the IV not even an hour ago. So basically I felt absolutely terrible and incompetent for the rest of the day. And worse, I will be working with this same nurse for the next month. I feel like I could write a book titled "How to make your preceptor hate you 101." Oh and even worse, this is the unit that I would like to be hired into when I graduate in 6 months.

The nurse continually told me throughout the day not to feel bad, that it wasn't that big of a deal, but I know it was. This patient was a critically ill patient. She needed that IV access. Thankfully they were able to place a midline in her later on that day, but still. It was completely my fault that they had to do that. I guess now I am asking for advice on how to mentally move past this, and how to make it up to my preceptor. Are any hopes of becoming a PICU nurse completely ruined? Because I sure feel that way right now. I am trying to let it go and go into my next shift with a positive attitude, but I just feel like I have ruined the whole thing by this one mistake. Any comments and/or advice would be greatly appreciated.

[Wuzzie]

OMG! You should just quit now and become a Walmart greeter!

NOT!

Okay, you made a bone-headed move. There isn't one of us here who hasn't. You just got an early start. ? I'm pretty sure your preceptor went through a few stages of negative emotions (pissed and irritated to name a few) and now she is perfectly okay. I promise you! I once had a student proudly show off the PIV she got in a fistula! Yikes! We went on to have a great experience together because any precepting nurse worth her salt knows these kind of things just happen. We deal with it and move on. In the whole scheme of things you made an honest mistake. It wasn't like you didn't follow a concrete process like the 5 rights of med administration. The patient needed more stable access before this incident ever happened. So now you need to pick yourself up, dust yourself off and make note that you are human and humans make mistakes. Go forth and be a great PICU nurse.☺️

[CatieK, BSN, RN]

1 hour ago, Wuzzie said:

OMG! You should just quit now and become a Walmart greeter!

NOT!

Okay, you made a bone-headed move. There isn't one of us here who hasn't. You just got an early start. ? I'm pretty sure your preceptor went through a few stages of negative emotions (pissed and irritated to name a few) and now she is perfectly okay. I promise you! I once had a student proudly show off the PIV she got in a fistula! Yikes! We went on to have a great experience together because any precepting nurse worth her salt knows these kind of things just happen. We deal with it and move on. In the whole scheme of things you made an honest mistake. It wasn't like you didn't follow a concrete process like the 5 rights of med administration. The patient needed more stable access before this incident ever happened. So now you need to pick yourself up, dust yourself off and make note that you are human and humans make mistakes. Go forth and be a great PICU nurse.☺️

Thank you so much for those kind words ?

[marienm, RN, CCRN]

OP, I'm sure you feel like you want the earth to swallow you whole. But the way to move on from this is to 1) learn from it and 2) actually move on. These are also ways you can demonstrate to your preceptor and more importantly yourself that this mistake is not the definition of your nursing career.

So, what can you learn...both clinically and personally... from it? Was the dressing on the new IV dated? (I bet all of yours will be from now on!) Was the bad IV marked in some way? Also, was there a reason night shift didn't just take it out if it was bad? (How would you handle this...consistent with any IV policies at your hospital...if it had been your patient?) Reflect on your thought process before you took out the IV: Did you think you were sure you knew which one to remove? Why did you think you were sure? Did you have any hesitations ("I thought they said the lateral one but they're both kinda lateral...") If you weren't sure, what stopped you from asking your preceptor for another set of eyes (fear of looking silly, rushing because you felt behind, self-doubt, etc?). How would you trouble-shoot this if, let's say, the access team placed the new IV while you were in another room getting shift report and you didn't know which one was new?

And how do you move on? You have the thought process above. You reflect that the patient didn't have a terrible outcome from this (it sounds like they needed that midline anyway!). And then (and this is hard!) you stop dwelling on it. You don't apologize endlessly to your preceptor about it. (Don't get me wrong, one apology is appropriate, and also to the patient as well as the VAT team, but when you apologize over and over the people you're apologizing to start to feel like they have to comfort *you.*). You're not going to forget this, so the best thing to do is genuinely make an effort to learn from it and carry what you have learned into your future practice.

[JamiePedsRN, MSN, RN]

I know it is easier said than done, but please don't beat yourself up. We have all made mistakes, it happens, we are humans. Luckily this particular mistake, while probably really frustrating and inconvenient, did not cause any significant harm. 

In PICU there are a lot of things that can happen. Patients are accidentally extubated, lines and tubes get pulled, a glucose drops too fast, the possibilities are endless. These things happen to new nurses as well as the rockstar nurses who have been around forever. It makes you feel like crud, but you have to learn from it and move on. 

Marienm had great advice. Apologize once but then let it go, I'm sure your preceptor is over it and has no hard feelings. She was a nursing student once too. Enjoy the rest of your PICU experience, it is an awesome specialty!

[canoehead, BSN, RN]

Facepalm! It happens to everyone.

If an IV is bad, just take it out at the time. Before you put the next one in. You or someone else could infuse into the bad IV, or you could remove the good on by mistake (it happens) if you wait. Plus there might be a juicy vein under that dressing.

[Orca, ADN, ASN, RN]

On 12/5/2020 at 5:06 PM, canoehead said:

Facepalm! It happens to everyone.

If an IV is bad, just take it out at the time. Before you put the next one in. You or someone else could infuse into the bad IV, or you could remove the good on by mistake (it happens) if you wait. Plus there might be a juicy vein under that dressing.

This is what confused me about the situation - why the bad IV wasn't removed at or before the time that the new one was placed.

[CeciBean, ASN, RN]

EXACTLY! Seems like someone else fell down on the job...or got busy and just forgot.