What's the worst nursing mistake you've done or seen someone else do?

macawake, MSN · Aug 2, 2017

Hi wise and wonderful Nurses!
I'm hoping to be accepted into a BSN program for the Spring 2018. I know I shouldn't think too far ahead, but I am already worried that I'll graduate, and make a mistake that'll get me fired. I believe that I can learn from other's mistakes, so I'm wondering if any of you would be willing to share some of the worst mistakes you done or seen someone else do? Thanks in advance!!

Welcome to AN :)

I think that you are thinking too far ahead. You are years from graduating. For now focus on absorbing as much knowledge in school and at clinicals that you can.

Your primary concern as you start your nursing career shouldn't in my opinion be that you could make a mistake that could get you fired, it should be that you could make a mistake that harms a patient. The worst nursing mistake I've seen cost a patient their life. I'm not entirely convinced that hearing a lot of nursing horror stories will make you a better nurse. Instead focus on what you can do to be a safe, conscientious and competent nurse.

We're human, human beings make mistakes. We can only do our best to keep them to a minimum and make sure that the mistakes we do make, aren't because we're being sloppy, lazy or wilfully ignorant.

I'll share a few tips, but please know that if you feel that you have no idea what to do with most of the advice right now... That's what nursing education is for. You will learn a ton of new things in the coming years.

Breathe :)

* Advocate for your patients. Always.

* Listen to your patients! They know their own bodies better than you do.

You might know more about the nitty-gritty details about the physiological processes in their bodies, but they LIVE in it.

* NEVER skip over safety rules regarding medication administration.

* Learn/understand the rationale behind orders. Ask or find out the why.

* Even as you've completed your formal education, NEVER stop learning! Invest time in continuing education.

* Don't EVER pretend to know what you don't know.

* Learn about the medications you administer and use the resources available to you (pharmacists, drug reference guides etc.)

* Learn to organize and prioritize your work.

* Familiarize yourself with your facilities' policy and procedure manuals.

* Respiratory rate is often the overlooked vital sign. Respiratory rate can be an early indicator of physiological changes/deterioration.

* Listen to your "gut feeling"/instinct. It will develop over time but even as a new nurse, if you think something might be going on with your patient, ask a more experienced coworker for advice.

* Make time to socialize and engage in hobbies/leisure activities and get plenty of exercise to strengthen your emotional stamina/resilience. Nursing can be stressful and we owe it to ourselves to take care of us.

I wish you the best of luck and much happiness in your future career!

ILUVERNSG, MSN, RN · Aug 2, 2017

Agency nurse in Florida was infusing a bag of Cardizem into my grandfather as a secondary medication at the rate of 100 ml/hr. I just happened to walk in and check at the right time. She was not fired although this could have KILLED my grandpa if I had arrived even just a few minutes later. She wasn't even apologetic. Still makes me angry to think of it.

brownbook · Aug 2, 2017

Macawake's comment is all you really need. Hearing horror stories of mistakes is only going to make you nervous, fearful, etc.

It is better to ask how to avoid mistakes.

The, so far, relatively minor mistakes I have made have been when I am rushed, and this has often been pressure I put on myself, not a doctor or patient rushing me! (Minor mistakes, , but I still feel awful about them years later!)

It can take 60 seconds or less to re-read a doctor's order SLOWLY AND CAREFULLY, it can take 60 seconds or less to re-read a drug label SLOWLY AND CAREFULLY (three times).

It is really hard to kill or seriously harm a patient with one medication error. The extra seconds or even minutes to stop and think, re-read, can save you days of regret, paperwork, even losing a job.

Saying aloud to a patient before you give them a medication can help..."This is your blood pressure pill, lisinopril." The patient may say..."The other nurse just gave me one...or I don't have high blood pressure,.....or I am allergic to that pill."

AnnG_ · Aug 2, 2017

Thank you, macawake, for the information and your advice. I agree that I should not be worried about getting fired, but rather, about harming the patient. As soon as I posted the question, I thought about that!

AnnG_ · Aug 2, 2017

Thank you, brownbook, as well! I think that rushing and making a medication error is what I'm worried about most. As macawake said, I am years away from being a nurse, but when I'm close to autonomy, I'll revisit this thread for reminders on how to avoid mistakes. Thanks again!

allnurses Guide · Aug 3, 2017

I've only once ever seen a nurse fired for a medication error. The reason she was fired was because she tried to lie about it and cover it up.

I watched her give the wrong medications to the wrong resident. When I pointed it out to her, she snapped my head off and told me bugger off and that I didn't know what I was talking about. I reported it to the charge. I am no narc, but come on!

Upon checking the med supply and the MAR, they found that, yes, she had lied.

She had demonstrated that she was dangerous. Imagine if the resident had started to have serious effects from the wrong meds... and no one would have known what the heck the problem was. Well, no one except the lousy nurse who would have, no doubt, kept her mouth shut to save her own ample butt.

Oh, wait! I forgot about the evil nursing instructor that double dosed a patient with Norco (patient was fine) and then tried to blame it on the staff nurse. The instructor had not checked the MAR. When the staff nurse didn't let herself get thrown under the bus, the instructor tried to blame it on the poor student. That was the last clinical that woman ever taught. Amen.

Bottom line, we all make mistakes, but admitting to them (for the patient's sake!) makes all the difference in the world.

Leonardo Del Toro, RN · Aug 4, 2017

Funny, but the more worried you are about making mistakes, the more prone to make them you are. At first most nurses have anxiety about making mistakes. With experience they become more relaxed and more self confident. However, you should never be too relaxed, or you'll make a mistake. No matter how good you are, you'll always make a mistake. So when you are around dangerous drugs, that can cause serious reactions or side effects, you double, triple and quadruple check and you keep doing to the end of your days.

TriciaJ, RN · Aug 4, 2017

Rule #1: We all make mistakes.

Rule #2: Never try to hide a mistake. Report it to the appropriate person and complete an incident report. The one you cover up will be the one that comes back to bite you.

iluvivt, BSN, RN · Aug 4, 2017

You are getting way ahead of yourself here Before you can even begin to analyze mistakes that could harm or cause the loss of life you need to have at least a good understanding of what nursing entails. The only way to get there is one step at a time. So have others have so eloquently stated you need to take one step at a time. Your fear will slowly dissipate as you learn and grow in this profession. Of course you are fearful now because you don't know anything yet or very little. So commit to the hard work and your fear will lessen.

blondy2061h, MSN, RN · Aug 4, 2017

I've seen several horrifying mistakes, thankfully none of which have resulted in serious harm. I can think of probably half a dozen serious mistakes with high risk medications off the top of my head that I have personally witnessed, one of which I was directly involved with. Thankfully, no harm in any of them. Two of the mistakes I'm thinking of were done by the same nurse. No one has gotten fired. Because they reported the mistake and took immediate corrective action.

The only time I heard of someone getting fired for a mistake was a time when they went back and lied (badly) and tried to cover their trail, including falsifying charting, to hide their mistake.

bluescrubs, ADN, ASN, RN · Aug 4, 2017

Don't plan to fail, nursing school is exciting and scary at the same time. I'm taking the HESI on the 15th and telling myself everyday that I'll pass and get into nursing school. You have to speak your dreams into existence. Have confidence :)