I've made a mistake, and now I need help

Meriwhen, ASN, BSN, MSN, RN · Mar 30, 2012

IMO, I would be honest and tell the doc: better you own up to the mistake than for it to be discovered later and the doc realizes you didn't tell him.

Ginger80 · Mar 31, 2012

I would just be honest: things like this happen. It's not the worst mistake in the world.

Fix it now rather than have it come back and bite you in the behind.

I bet you won't forget the consent form ever again! :nurse:

FutureRN_NP · Mar 31, 2012

I would say let him know and be remorseful in front of him. He might spare you which I am very positive he would. Honesty is the most valuable thing we human own.

ckh23, BSN, RN · Mar 31, 2012

Be honest. Hopefully he will be forgiving. He also is at fault because he did not sign it either.

holdyourheadhigh · Mar 31, 2012

Thank you for responding. I am usually good about admitting my mistakes but this is going to be difficult for me to do since I feel like my job is on the line. I am still in my probationary period so I'm even more nervous.

I was planning on telling the head doc, not the one who did the procedure. I would be more comfortable telling him, what do you think? They won't both be working Monday. The head doc would be the one responsible for calling the shots on what happens to my job. The doc whos pts it was is also leaving the clinic to work elsewhere in 2 months.

I just can't believe it. I feel terrible.

Dianesrn · Mar 31, 2012

The best thing is to remember what your mother always told you. "honesty is the best policy". We all make mistakes. You will be surprised the doctors are human too. Don't be afraid to address it, get it out in the open and get it over with. You won't be able to live with yourself until you do, and if you don't say anything and it is found, you will certainly be in trouble then. I think it will eat you up inside until you just get it out and talk to the doctor. This may feel like a "big" mistake, but honestly it is paperwork. It can be amended. You will face many dilemmas in your career, honesty is always best..

FutureRN_NP · Mar 31, 2012

I say do what your guts tell you. If it is safer to talk to the head doc who the one will decide your faith anyway then do so. If he is okay with it more likely than not the other doc will be as well. Doesn't the document become a permanent record after the procedure completed?

holdyourheadhigh · Mar 31, 2012

it is a permanent part of the chart, this particular paperwork comes as a handout that has up to five or six lines of pt/doctor signatures of this particular treatment so they sign a new line every time they come in for it. a nurse only has to witness the first consent to treatment and the subsequent lines are just pt signature and doctor. but like i said, we usually have the patient consent and then hand off the form so the doctor just needs to sign off.

aside from the head doc calling the shots when it comes to employment, i work with him more often and he is a little more calm and collected.

if this situation or a similar situation has happened to anyone you know or have heard of, how did they go about correcting it? sign it on the next visit or just inform the patients? i'm not sure what generally happens at this point.

FutureRN_NP · Mar 31, 2012

I would say ask the head doc first for the guidelines. He can call the shot if pt needs to be contacted and obtain late entry signature. I would not go out about anything until further advise from him. This way you are practice and act according to the facility's protocol. I don't really know anyone who had been in this situation. All I can say is that what I would do. You are a new nurse and if this is your first mistake they should understand. Lets us know what you had decided and how it went. Good luck!

Whispera, MSN, RN · Mar 31, 2012

I see two ways of approaching this. The first is to tell the first doctor you see when you're back at work, that is involved in the situation--either the head doctor or the one who should have signed off. That way you've reported the error ASAP. The second is to tell the doctor who signed off because he is the one directly involved, and it could come back at him as well as at you. He wouldn't be too happy if you went over his head without telling him first, when he should know he goofed too. He might appreciate you telling him.

I don't see that you'd be fired. People make mistakes. Admitting them is important though. We can't just slip them under the rug and hope they aren't discovered.

I think a late entry signature could be better than no signature. It's obvious the mom approved the injection because she went through it and allowed her daughter to go through it too. Also, it wasn't the first time she went through it, so she knew what it was without being told. Getting the signature each time is protocol, but not quite as important as getting it the first time.

Wishinonastar, BSN · Mar 31, 2012

This is very hard to deal with. Informed consent is essential. I have found charts during audits with consents that were not signed by the patient. It does happen. The patient gave verbal consent by permitting the procedure. The consent form is proof of that. It is a safety net for you and the doctor. I agree it is a detail, and paperwork. It is not the end of the world. Much worse if it was a major surgery or something.

As a QI nurse I will say that this points to a weak link in the chain. You need a system in place to make sure this does not happen again. Otherwise, it will. Both of you are at fault. Your part was not done, and the second key event of the doctor signing was not done by him. How can we make this never happen again? Perhaps a checklist on the chart that travels with the patient that EVERYONE must look at to see what has been done and what has not been done. Before the patient leaves every essential step must be checked off.

Chances are it will be caught somewhere eventually. It is tempting to pretend it did not happen, and a lot of nurses do this with their mistakes. That is a widely known fact about all people, not just nurses. It takes much more strength to admit your mistakes, but in the end it is better than being caught in an audit.

The patient will probably need to be called and this incident written up using whatever method they normally use for such errors and events. You will make mistakes on probation, that is expected. Your next step is up to you, but my gut tells me to go to the top and tell the doctor in charge because the one who also did not notice his part may try to make a show of blaming you. I doubt you will be fired for this, but they will watch you closely for any other errors. Admitting your mistake will reassure them of your character. I may be wrong, but I think only the worst kind of hothead would fire you for an admitted error that you are sincerely apologetic about. Perhaps if you make a suggestion of a way to stop this from happening again would help?

I will say a prayer for you.