How To Overcome Mistakes As A Nurse

Everybody makes mistakes, and nurses are no exception. In another brilliant video, Registered Nurse Claire shares her great advice on overcoming mistakes, drawing on her own experiences.

Hi everyone. Welcome back to another video. Today's video is going to be talking all about nursing mistakes, but also how to overcome this if you've ever made one.

Statistics On Nursing Mistakes

So firstly, you know me, I've got my laptop because I want to see some statistics of nursing general mistakes. However, when trying to research how many nursing mistakes are made per year, for example, within the UK, it only comes up medication errors. I don't know why.

But anyway, what have I found? First, types and causes of medication errors from a nurse's point of view. This was a study that was done a while ago. What was the date of the study? 2013. So it is an old study. So, we know that these things have happened for a long time, and the results of this study showed that medication errors had been made by 64.55% of nurses. And the most common type of medication error was down to dosage or infusion rate.

The British Medical Journal 2020 says there's around 237 plus million medication errors made every year in England. And avoidable consequences cost the NHS up to 98 million and 1,700 plus lives every year.

The harms caused by medication errors has also been recognized as a global issue, apparently. This is why when I'm searching, medication errors are everywhere.

And guess what? I hold my hands up. I have absolutely made an error within nursing, and guess what? It was a medication error. And I had no idea that this was so common in the UK.

But why? Why are we making such errors? I can only speak from my own personal experience; I know exactly why I made that error. So, it's story time.

Making A Mistake As A Nurse

When I was a GP Nurse, I had this patient. They were a young person, so they were under 15 years old and I'm not going to give too much away, confidentiality and all that jazz. So, I had a young patient, and they were coming in for a hormone injection.

Now for this particular hormone injection, I'd given it to many patients before, but they'd all been adults. And then when they brought it in, I looked at the prescription, but I just misread the label and I read 250 mils in a mil. I saw the mil and I thought, I'm given a mil.

I didn't read the below line in tiny small print that says 0.2 mils. So, I went and I give this child a full mil of their hormone on that day, and off they went. They left the room and for some reason I double checked the packet, otherwise I would never have known, and I would've just given it and not even have realized. I checked the packet, and it was then that I saw the 0.2 mil. The dread and the sheer fear in my heart, as the sweat was pouring off me, my heart was going so fast, and the colour drained out me.

I was actually working with a Nursing Associate at the time. I was training her up and she looked at me and she was like, "What's wrong?" And I'm like, "I've given the wrong dose to this patient." And she was like, "What?" And then we went through it together and she said, "That's fine. Let's just go over it and let's just see what we can do about the situation."

So immediately I went, and I told my manager, and I told the GP in charge that day and they both said, "Don't worry about it Claire, let's just document it. Check with the child. Make sure you follow up with the mum to let her know what's going on and what's happened and to look for any side effects and things like that, no problem. But also contact the Endocrine Society."

The Endocrine Society had actually prescribed this hormone to the patient. So, I had to call the Endocrine Society. I explained everything and they looked at the BMI of the patient and everything and luckily it was actually okay. They were actually given less of a dose as they can have up to one, two mils of this. So, it was actually safe in this scenario and luckily the patient was okay.

However, that's not okay. I still made that error. I still gave too much of a dose of a medication and that should never have happened.

An Opportunity To Learn

Now, one thing that I am very good at is self-analysing my emotions, and why things have gone the way that they have; I'm really good at self-reflection and I will analyse everything to make sure that that doesn't happen again. I analysed this situation over and over and over in my mind every single day. I wrote a reflection about it and just to gain a deeper understanding of why I did that.

Because yeah, I made a medication error. But unless you understand the reasons why it happened, you could potentially make that error over and over again. So, this is why it's really good to reflect and understand why you did that, as well as putting things in place so that it never happens again.

And what it come down to was many things actually. One, I was rushed off my feet that day. Two, I was training a member of staff and I was trying to get things right for her as well as my patient. Three, I just completely read the prescription completely wrong.

Where were my five rights of medication: right patient, right dose, right time, right route, right medication? All of that should have been embedded and for some reason my eyes just did not see the dose. For whatever reason, I didn't read the prescription right for that day. Probably because I was so busy and I was distracted, I was doing all these things.

And actually, there's a lot of things out there that say when medication ward rounds are being done out there, in hospitals for example, you should have minimal distractions.

In nursing you will absolutely make a mistake at some point. We will make a human error every once in a while.

Changes Made To Minimise Mistakes

Some places use the red bib now. I don't know if you've seen that out there, if you have let me know in the comments, but there's a big red bib that nurses wear saying “drugs round taking place do not disturb”, that's been quite effective at stopping people from being distracted from their drug round, because it's just one of the problems that's happening out there unfortunately.

And I can tell you now, I have never made that mistake again. And that is a result of good reflection, but also being very fearful of ever doing that again. Because once you make that mistake once, you really don't want to make that mistake again.

So, literally every single patient I had, I checked their name, their date of birth, the medication I checked the dose on the box, the packaging, but also the prescription that they had on the computer system as well.

I was checking every angle possible for every patient I had to avoid that happening again. I was making sure that I haven't got any distractions. I knew that patients were coming in for their hormone injections. I was making sure the room was quiet, I wasn't going to be disturbed, putting a do not disturb sign on the door, and making sure I've got everything at a minimum so that I don't get it wrong again.

Every Nurse Makes Mistakes

Now, in nursing you will absolutely make a mistake at some point. We will make a human error every once in a while. We will absolutely make mistakes in nursing, whether it's doing an injection wrong, whether it's getting a dose wrong, whether it's getting the times wrong, whether it's doing a blood pressure not quite right or documenting the wrong thing in the wrong notes.

There could be a whole variety of things that happen out there because of the pressures of nursing, because of you being under pressure. Shortage of staff is going to have a massive impact on it as well. You could just have one of those days and make the simplest of errors, but they could have a big impact on your patient.

So how do we overcome that if that happens?

Just reflect upon it, debrief, report it… And that's it. Just let it go because that's all you can do. Don't let it steal your peace.

Report It

The first thing you're going to want to do is obviously report it. Make sure you're filling out your instant report forms, report it to your mentor, report it to the doctor, just like I did. You have to be open and honest about your mistakes because otherwise if you are hiding things, it's not going to look good. That's for sure.

Reflect On It

Reflection. This is why we have to do reflections for our NMC revalidation every three years, because it is crucial that you reflect on yourself and the situation.

And if you do your reflections right, then you will get to the bottom of it and it'll prevent that from ever happening again, hopefully. Fingers crossed.

And that is my first tip for overcoming mistakes. Really reflect, dig deep down inside your soul and really get out the root cause why you have done what you've done, what has happened, and make sure that that never happens again.

Debrief With Someone You Trust

My next tip as well is to debrief. If you've made a massive error, or even a small error, it can make you feel so bad, so anxious, or so awful you might even want to quit your job because it gets so anxiety inducing.

Please debrief with somebody. Debrief with your mentor, debrief with your colleagues, debrief with your family or your friends. Have a big debrief with somebody just to get it out and have that reflective discussion in a way out loud with somebody just so that you can feel better, and you can understand more about yourself.

But also have a peer perspective as well. There's a lot of evidence that says peer perspective is really, really good, and really beneficial for us as nurses as well, because it gives us that different perspective. We can be so hard on ourselves. And actually, there's a lot of research that says that, that peer support observations from your colleagues can be massive benefit to you.

Just having that different perspective can just be such a benefit in this sort of situation. So make good use of that.

Take Some Time Out

Make sure you take some time out because something like that, like I said, can be such an anxious time. Make sure you take yourself out of the situation. Just get away, have a cup of tea, have some cake, have a jog, whatever you want to do, just to take some time out and just clear your head during it. That is going to make a world of difference, I think.

Look At Your Organisation/ Trust Guidelines

Have a look at your organisation or your Trust or wherever you're working. See if there's any guidelines or policies on nursing mistakes, things like medication errors, or if something else has happened have a look to see if there's a guideline there, say, what to do in this has sort of event.

If there's nothing out there, speak to your manager and see if you can have something put in place or see if you can help create that for them. Don't be afraid to have things put in place because we can all learn from it; if you've made that mistake, someone else could potentially make that same mistake as well. So having something in place is going to make a massive difference.

Don’t Beat Yourself Up About It

And finally, don't beat yourself up about this like I did. I spent days panicking, in an anxious state, really going over and over it in my mind, beating myself up every single day. And I know it's really easy for me to say, don't beat yourself up about it because I was that person doing the exact same thing.

But mistakes happen. Like I said, we are all human. As long as you've reported it, you're open and honest about it. You're protecting the patient, at the end of the day. You're preventing further harm. That's the best thing that you can do.

Just reflect upon it, debrief, report it, make sure everything you can do in place. And that's it. Just let it go because that's all you can do. Don't let it steal your peace.

Remember Your Achievements

Think about all of the goals you've achieved, the patience that you've gained, a difference due to this one tiny blip or this one mistake doesn't need to be the centre of your attention.

Try and just put that to the side as long as it's been dealt with and reported and everything. Put it to the side and remind yourself of all the positive things that you've done, all the difference that you've made to your colleagues, the patients in front of you, and just take a big, deep breathe.

So I hope that's been useful in some way. I hope you've taken something from this video, and that it helps you move forward if you have made a mistake or if you haven't made a mistake, you have these tools to put in place just in case that ever happens.

But for now, it is goodbye from me, and I shall see you next time.