Surviving Your First Nursing Mistake

Keith Carlson, BSN, RN, NC-BC

Keith Carlson, BSN, RN, NC-BC

Every nurse makes mistakes — it’s simply inevitable. And when you make your very first mistake, it can feel overwhelming, shameful, and like the end of the world. In most cases, your first mistake will not be your last, and how you respond that very first time can set the stage for how you respond in the future. The truth is this: mistakes happen, and you’ll survive.

Mistakes Happen

There are likely precious few nurses who’ve never made a mistake; and if a nurse tells you she or he has never made an error, they’re probably lying or in denial.

Let’s face it: in the high-stress world of 21st-century healthcare, things are going to happen that you’ll regret, whether it’s a forgotten medication, a wrong dose, or something worse (or not worse) than that. And yes, some mistakes lead to patient harm or death – there’s no way around that fact.

The truth of the matter is that you will indeed make mistakes, and in your first few months or years as a nurse, you may make quite a few. Hopefully, no one will be grievously harmed by your error, but you also have to be prepared for the worst and know how to react appropriately when something bad does happen. And just remember that your silence or denial won’t protect you when you’ve done something wrong; you simply have to own up to it and face the consequences.

And when a mistake happens, remember this cardinal rule: patient safety trumps everything else, including your pride, your job, and your nursing license.

Report, Document, and Cooperate

When you realize you’ve made a mistake, the first thing to do is not fall into the slippery slope of denial since it’ll probably bite you in the gluteus maximus down the road. If you make an error, go straight to your manager, director, or charge nurse, and report the error immediately.

When reporting your error, consider the following:

  • Describe exactly what happened
  • Swallow your pride and make no excuses
  • Be 100% truthful, honest, forthright, and cooperative
  • Own your behavior and your error
  • Ask the person you’re reporting to what they want you to do next
  • Document your error with complete honesty and clarity
  • If there was a witness to your error, involve them in the reporting and documentation
  • Comply with every aspect of the investigation and the consequences
  • If the Board of Nursing is involved, be as honest and forthright with them as you were with your employer/manager/supervisor
  • Use the situation as a learning opportunity
  • If there’s a legal situation, contact your liability insurance company and file a report on day one
  • Consider engaging the counsel of a lawyer (preferably a nurse who’s also a lawyer, or at least a lawyer well-versed in nursing and medical malpractice) before signing any agreement or admission of guilt

Move on and Forgive Yourself

Your process of recovering from the trauma of making a mistake will likely depend on the severity of your error. Nursing mistakes are not created equal, so your reaction to what happened can look different based on the circumstances and details of the incident.

Most mistakes don’t necessarily cause grievous harm or death to a patient, and that’s a good thing. If your error was easily fixable and there were no lasting effects, count your lucky stars, forgive yourself, learn from your mistake, and move on.

If some harm was caused by your error and you need to pay some kind of dues or penalty for your actions, so be it. Accept that you made a mistake, take part in whatever corrective action has been prescribed, and then do your best to go forward with your career.

Your employer may have an Employee Assistance Program (EAP) offering free counseling to staff members in need, so consider reaching out. These counseling sessions are generally considered confidential, with no information reported to your employer (even including the fact that you’ve taken part in EAP services at all).

If the incident is haunting you and causing fear, anxiety, lost sleep, or other symptoms, consider psychotherapy or counseling, if only briefly until you’re back on your feet again. If a patient died as a result of your actions, some longer-term therapy or counseling may be in order. Causing harm to another human being can take a toll, so be on the lookout for symptoms that need attention. Your faith leader may also be a very powerful source of support and spiritual comfort.

Forgiving yourself for your first nursing error may feel daunting. It can be embarrassing, and you may feel a fair amount of shame about what happened. If the situation becomes fodder for gossip or bullying, be aware of the impact on you and reach out for support from trusted colleagues or managers.

In the end, forgiveness is key, and getting there is a very individual journey. Remember not to isolate, blame others, withhold information, or be untruthful. Stay clear, calm, and focused on the facts, and get support when you need it most. Don’t beat yourself up about it;  courageously face the consequences and move forward.

You will recover from this situation and move on. And when you look back on the incident, the learning opportunity it provided for personal and professional growth will likely be the silver lining that overpowers a very dark cloud.

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