Mistakes in practice

[ClareLara]

Hey this is my 1st post, I'm in my final year of being a student nurse and last week I made my 1st potentially major mistake on placement. We were short-staffed and it was just me, a bank nurse who wasn't very familiar with the ward and a healthcare assistant. The bank nurse was relying on me a lot to help her as she was unfamiliar with the ward but it was only my 2nd week on the ward and although I was familiar with a lot of things and knew important things like what to do if a patient crashed, I was still not totally clued up on some things. On this ward we have a lot of patients who end up staying for a long time - it is only a 10 bed ward so you get to know the patients well which is nice.

In my 1st week I had done 1 admission with another student nurse and as the ward still uses paper instead of the computer, there was a lot of paperwork to do and it seemed quite disorganised compared to other wards I'd been on. Anyway we had 2 admissions and I was trying to get mine done but the bank nurse kept interrupting me and asking for help and how things were done which I didn't mind but it meant it was hard for me to focus on the task in hand. I was also helping the healthcare assistant with some of the patients as they needed assistance of 2 to get into bed/for toileting. So I felt a bit all over the place! Anyway I went through the admission with my patient and asked for his allergies - he was in his 80s and said he had none. His close relative was with him and so to double check I asked her too and she said he had none. As the patient was admitted directly from the community I had no old hospital notes to look through, i'd requested a summary from the patient's GP and got that at some point. It was a long summary and I looked through but couldn't see any allergies. I was going to double check on the system but needed the bank nurse to look for me as as a student nurse we aren't allowed a full login only a restricted access one.

Anyway with it being so busy I forgot to check and it turned out there were allergies recorded on the summary (albeit in a bit where it was easy to miss it out) and when I came on the next day the night nurse said she'd found some allergies. Thankfully they were old drugs which are rarely used now and the likelihood he'd ever be given any of them was tiny and he wasn't written up for any of them anyway but it just shook me how I could have missed something so important! Especially as I'm in my final year and feel like I shouldn't be making mistakes like this. The other nurses were fine with it and said not to worry but I can't stop thinking about it and feel like a failure :-( I know this may sound a bit harsh on myself but I think I set high standards and like to live up to these. I suppose I've learnt to look even harder now for allergies and in future to just get my head down and finish the admission rather than get distracted by others.

Has anyone else had similar experiences?

[K+MgSO4, BSN]

O sweetheart you shouldn't of been put in that situation. You made an error by being put into a dangerous situation, I have been there myself as a final year. I am guessing by your terminology you are either in the UK, Ireland, NZ or Australia.

You were put in a situation where the nurse manager should of stepped in, either taking a load, calling in a regular staff member or offering someone overtime. As a student you were trying to do your best for your ward and your patients, the bank nurse was also in a dangerous situation who should of advocated for herself and her registration.

I was caught in a situation of being a 4th year student on nights, economy in the tank in Ireland, I was covering a RN on sick leave, the other RN was newly qualified and next to usless. I ended up running the respiratory care unit with 3 on bipap as well as assisting with 12 other pts. We had a code blue that night. The nurse went to pieces and I ended up running the code till the twam appeared. Pt didn't make it but had massive medical history.

Anyway, talk to your placement coordinator or whoever is your link tutor, ask them to support you in a conversation with the ward manager, you need to do this. Have a chat to your union as they can assit you with how to stand up to these situations when they happen again.

Use this situation, not mentioning the ward of course when you are doing your interviews. I am here if you need to talk.

[NurseGirl525, ASN, RN]

I am surprised you were put in a situation like that. I'm assuming you are not from the US but here, we cannot do anything like admissions and stuff. We really can't do anything without an instructor present. We have to show we are competent in an area before we can do it. Also, if the patient himself told you no allergies, then I wouldn't worry about it too much. Especially if you had no accompanying paperwork at the time. Where was your clinical instructor? Like I said, I'm pretty sure you aren't from the US so I have no idea if things are different where you are, but I would think you would have had an instructor somewhere.

[ClareLara]

Thanks for the comments, it's made me feel a lot better! I'm from the UK and once we have been seen to be competent at something we can do it without someone watching directly although our work should always be checked. I've done tons of admissions before and never missed anything so this shook me up a bit. I am definitely going to speak to the manager about it as we've been short staffed a lot lately. Admissions take a long time on this ward as there is much to fill in but then there are other things going on too so it's hard to get it all done at once. We have mentors rather than clinical instructors over here in the UK but don't always work with them. It's amazing how many patients don't know they have allergies, on another placement I had a patient who said she wasn't allergic to anything but when I looked in her past history she'd had quite a severe reaction to morphine. I'm now going to be even more careful when checking for allergies!

[annie.rn]

You sound like a wonderful, very conscientious student who will be an excellent nurse. Don't be so hard on yourself. It sounds like you did everything in your power to gather an accurate health history on this patient. He told you he had no allergies and you had no documentation available to tell you otherwise so documenting that he was allergy free was appropriate at that time. In the future, if you doubt the veracity of the information being given to you by a patient, you could document that and report off to the next shift that records need to be obtained in order to verify the information given by the patient. Good luck to you and keep up the good work :-)

[classicdame, MSN, EdD]

Competence and expert are not the same. A competent nurse should not have been in a situation that demanded more expertise. However, I think you did well under the circumstances. We all make mistakes. Do not beat yourself up over it. No one was hurt and you learned from it. That is enough.