You Made a Nursing Error – Now What? 

I will never forget how terrible I felt after making my first nursing error. As soon as I realized what had happened my heart dropped. I was a novice critical care nurse at the time. I had just received a patient from the emergency department and was still settling them into the unit. During that time my other patient’s blood pressure dropped. I notified the provider, and they said to go ahead and give the patient a liter bolus of normal saline. I went to the supply room, grabbed my liter, threw it up on the pump, and went back to admitting my patient. After an hour, the pump alarmed, and I went to address it. That’s when I saw my mistake. Instead of grabbing a liter of normal saline, I grabbed a liter of D51/2NS. 

Two very different fluids. 

The flood of emotions that followed included everything from: fear, anger, shame, mistrust in myself, and anxiety. I had the question of:

Should I even be a nurse? 

Fourteen years later, I still remember this incident. Plus, the other two mistakes I made in my career when I had more experience.   

When I talk with my new graduate critical care nurses about what they’re most anxious about, a common answer is: making a mistake.  

No one wants to make a mistake, and I truly believe that most try with the best intentions to live up to the unrealistic expectation of perfection that has been preached to us from nursing school. 

But, here is something I want you to know: Every nurse is going to make a mistake at some point in their career. If they say they haven’t, it is probably because they simply don’t know the mistake they made, they are lying, or they haven’t made one – yet

I don’t say this to normalize making mistakes, I say it to open a conversation on what we do about it. 

Yes, there are steps to take after making a mistake. Like telling your provider, leaders, correcting any issues, and putting in an incident report. 

However, I don’t want to talk about those things. I want to talk about how you learn to forgive yourself and move forward…because your brain and heart are important.  

Here are some practical things to do when you are in the height of beating yourself up: 

  1. Be Patient. Have you ever had to forgive anyone in your life? Did it happen quickly? Probably not, and the same is true when it comes to forgiving yourself. Typically, we are even harder on ourselves than others, so add that layer into the mix. Self-forgiveness can start once we take ownership and responsibility for the mistake. This means we must face the hard truth that we messed up. Avoiding responsibility drastically prohibits us from moving to any of the next steps. 
  1. Talk About It. You are going to feel pretty crappy about yourself. You may have feelings of shame telling you that you are a horrible nurse and should just go work somewhere else. This is why it is incredibly important to talk about it. Shame thrives on secrecy. It can only continue to exist and grow in the shadows. When we break the silence, it allows us to experience outside perspectives, empathy, and reminds us that we are not the only ones who have made a mistake. The antidote to shame is empathy.  Trust me – every nurse can empathize with the feelings that come after making an error and are willing to remind you that you are totally worthy of being here. 
  1. Review and Reflect. Mistakes are some of our greatest teachers, but only if we are willing to reflect and learn about why it happened in the first place. When you are in a not so tender place and can truly evaluate – objectively – what happened during the mistake, do so. Reflection can assist with gaining essential insight to move forward. It let’s you see where the barrier was. Was it an educational gap? Was it a shortcut that you took? Was it a process problem in the facility? What can be changed to not have it happen again? 
  1. Be Proactive. Once you have had time to reflect on the mistake that happened, it is time to move forward. This is where you can take the answer to the question of: what can I change? And change it. Seek out more education, speak up about processes that need changed, don’t skip steps even if you are busy, double check things, slow down. This also means you get to be proactive in helping other nurses. Use this opportunity to teach them. Or maybe it means that you can now be the antidote to their shame. 

Mistakes have made me a better nurse. For my patients, colleagues, and students. The mistake I made above was a result of many things. One of those being that I didn’t follow the proper process of medication administration. I didn’t scan the bag before I spiked it. If I did, the eMAR would have prompted me to see that I had the incorrect fluids.

Whatever you do, please be easy on yourself. Learn, grow, and move on.