Mistakes

TheCommuter, BSN, RN · Nov 20, 2009

I have had that feeling after almost every shift I've worked. It always seems as if I might have forgotten to have done something, possibly overlooked an issue, or perhaps neglected to place a phone call. The job never quite feels done.

ONCRN84 · Nov 20, 2009

Daily. It drives me absolutely crazy. I go over everything I did at night, trying to think of things i may have not done and should have, etc. I'm stressed at work, I'm stressed at home, I'm anxious about it... ugh.

missmiamoore · Nov 20, 2009

Oh yes, of course we all do that. It's called reflection. The key is not to drive yourself crazy over these things. What I find helps is I try to think of a positive for everything I have missed. For example, I will think, I should of left a note for the doctor about the family's concerns. However, I did successfully advocate for the patient to have their pain medications changed in a timely manner. Just remember, everything you do makes a difference. Those things you think about at night is your way of processing the information and learning. This makes you a better nurse :)

iluvdetroit · Nov 20, 2009

I used to work the 3-11 shift and I would often drive home thinking over my just-completed shift and what I could/should have done differently. I think that a lot of us tend to blow up the bad things in our minds and diminish the good things. I know I am guilty of that. So many times, things that I felt really anxious about turned out to be nothing to anyone else, and things that I thought were just basic good care and no big deal would bring complements from others.Don't be too hard on yourself. Nursing is hard work, and in a typical nursing shift it would be virtually impossible to do everything perfectly or to remember everything that you should. That's why we get paid so well, because of the awesome responsibility of our jobs. You are probably doing fine and are just very conscientious.

systoly · Nov 20, 2009

You're right - it will eat you alive, because you're not getting any time off if your mind is still at work. Try to recall everything you did do in one shift. I think you will be amazed at how much you did accomplish.

RNperdiem, RN · Nov 20, 2009

Those feelings diminished a bit for me after my first couple of years of nursing, but they are still there.

That is one of the biggest sources of stress in nursing.

It is a type of stress difficult for people outside of the business to understand.

iluvdetroit · Nov 20, 2009

Those feelings diminished a bit for me after my first couple of years of nursing, but they are still there.
That is one of the biggest sources of stress in nursing.
It is a type of stress difficult for people outside of the business to understand.

Definitely, because most people outside of the medical field don't literally have peoples' lives in their hands every time that they go to work. For example, if I'm a chef and someone doesn't like their dinner and complains...well, at least no one is going to die from it (hopefully, lol!) or if I'm a teacher and I am having a problem with a student, well, their life isn't hanging in the balance. The critical nature of our jobs make them more stressful than many other jobs. NOT that jobs such as being a teacher aren't stressful, it's just a different kind of stress.

DogWmn · Nov 20, 2009

To some extent yes, but one of the things my clinical instructor really pounded into our head was, when you walk out the door, you've got to learn to leave it at the door otherwise you will drive your self nuts.

rn/writer, RN · Nov 20, 2009

Here are some tips to help you manage this occupational hazard.

Write everything down on your "brain sheet" that you need to take care of before you go. I perform light meter tests on newborns to see if they need blood tests for jaundice. I write that part at the beginning of the night, so I'll remember to do the tests. But then I write "forms" to remind me to fill out the sheet in each chart, which I don't always have time to do right away. I also write things like ordering breakfast for non-English speaking patients and calling pediatricians to let them know they have a newborn admission. Because I don't have to do these things every shift (and because I can't do them until the end of noc shift), they can fall through the cracks. One-word "ticklers" on my brain sheet help me recall what I need to do.

Keep track of things you have forgotten. See if there is a pattern. You might find you need to add certain things to your cheat sheet every shift. For instance, I used to walk out occasionally with either a zone phone or the narcotic keys. Hasn't happened in ages because I added KEYS and PHONE at the top of the sheet to jog my awareness. Other likely candidates would be things like I&Os, clearing out PCAs, checking recently drawn labs, etc. Often these are end-of-shift items that can be forgotten in the wrap-up rush.

Take some time at the end of the shift, even if it's just two minutes, to breathe and let your mind settle. It's amazing what thoughts can pop up when you slow down and let yourself rest. Take a mental journey through your patient list. A receptive mind can catch things a racing brain would just fly past. A gentle inventory can save you a lot of aggravation. Many times I offer up a quick prayer to recall any tasks undone or uncharted. I've been rewarded time and time again with the knowledge of something I needed to take care of before I left.

If you do forget something, evaluate whether it merits a trip back to the unit, a phone call, or just a mental note to do better next time. Some things must be taken care of in person, even if it means going all the way back to work. Examples would be leaving with keys, forgetting to waste a narc you found in your pocket, or writing down a telephone order you took. We all know that the last two items should be done immediately, but we also know that real life sometimes throws you a curve ball. You could call about things like forgetting to order a patient's breakfast (or even call dietary from your cell phone to do it), or any last minute things you forget to add to report. And some things you just have to release--forgetting a request for an extra blanket or juice.

Refuse to beat yourself up. That never makes a bad situation better. And it can rile you up and depress you so much that you become distracted and miss even more things.

Finally, after you have taken a few deep breaths, crossed off all the cues you left yourself on you cheat sheet, gone through a sensible inventory of your patients and the things you tend to forget, and have said a quick prayer (if that's something you do) to bring anything undone to your remembrance, close the book on that shift and let it go. At first this can leave you feeling kind of "wobbly," like you are doing something careless. But eventually, it becomes a very good habit that will help you relax and sleep well.

We all forget something at one time or another. But if you practice a systematic disengagement at the end of each shift, you will find it doesn't happen often.

I wish you the best.

ChristyRN2009 · Nov 21, 2009

I'm struggling quite a bit with this right now. It doesn't help that I used to work on the perfect shift and now I work on the busier shift that the perfect shift judges harshly. So I know what all I missed will be discussed ad nauseum later on. I think about that a lot. Its actually a contributing factor to my wanting to move on from this job, but I bet this kind of rumination will follow me to other jobs, based on what other posts here. It sucks I make some mistakes, miss things, don't do things to the standard that I would like to, seems like most shifts. And then I go home and think about it not just that night but days later.

sunnycalifRN · Nov 21, 2009

Everyone I know does this. Usually, as I'm driving home, it hits me and I realize something I forgot to do or forgot to mention in shift report. If it's just cosmetic, like "sorry, I didn't clean up this or that" . . . just keep driving . . . if it's important, I just pull over and call work and tell the oncoming RN. But, by the time I get home (15 mins), I'm paying attention to my tunes.