Rolling Hill nursing

How to Make Mistakes and Learn from Them - A Guide for New Nurses
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26

MAY, 2020

Every nurse makes mistakes. Let me say it again for the people in the back: every nurse makes mistakes. You will make mistakes. And that’s OK. Actually it’s great.

The mistakes you make will help improve your nursing practice and help you better understand how to avoid those mistakes again. It will also make you a better nurse and allow you to pass on that knowledge to other nurses in the future.

I have made countless mistakes, like the time I drove halfway home before realizing I still had my work phone in my pocket.

Let me tell you a little story:

It was the last hour of my third night shift in a row. Of course, it was my first time being floated to a different unit and I was tired, and feeling out of my element. This particular patient was non-communicative and had a nasogastric tube in. At some point right before the end of the shift, he had pulled his NG tube out. 

I didn’t want to push it off for the day shift nurse – I try to be a nice guy… sometimes. I quickly gathered all of my supplies and went in to place the NG tube. 

I was used to this patient gagging a lot, coughing, and generally acting pretty uncomfortable despite giving all of the possible PRN meds. So, when I placed the NG tube and he hacked and coughed and his eyes watered, I assumed it was just par for the course.

I apologized profusely for the discomfort, but explained why he needed to have it in. He continued to cough like he had been doing previously. Per policy, I called x-ray to come verify placement.

By the time x-ray came, I had given report to the oncoming nurse. The nurse practitioner on duty quickly checked the x-ray and said it was good to go. Right as I was leaving the floor to go home, I saw the day nurse get a phone call from the radiologist saying that the NG tube was actually in the patient’s lung! 

Everyone on the unit told me it was ok, they would fix it, and I should go home. They helped me remember that it can happen and that I shouldn’t worry too much about it. Obviously though, I worried about it.

I felt terrible for not only creating more work for the day shift nurse, but also I felt terrible for doing that to the patient. Not only is it TOTALLY uncomfortable, but I also didn’t trust my instincts when I noticed that he was coughing and hacking.

I felt like a terrible nurse for not being able to put in an NG tube properly.

In nursing, there is a huge range of mistakes, from little ones to potentially fatal mistakes. This is a lot of stress. When I was a new nurse, the stress of the mistakes I had made and the stress of the mistakes I could make really affected me. 

I felt constantly on edge, even when I wasn’t at work. I felt like my non-nurse partner couldn’t understand how stressful nursing is. It was not a good feeling. 

It wasn’t until I learned to process, learn from, and accept my mistakes that I started to feel more confident in my nursing practice. 

Read my steps below for how to make nursing mistakes well and learn from them.

1. Remember, Everyone Makes Mistakes

I recently watched this TED talk given by Dr. Brian Goldman that discusses mistakes in healthcare. Dr. Goldman is a successful emergency department doctor and he describes occasions when he has made mistakes. I recommend watching it, because he makes such excellent points. 

There is a belief in healthcare and nursing that we all have to be perfect, that mistakes can’t happen. Yes, we should try to reduce mistakes and make sure that we are keeping our patients safe. But we all make mistakes.

Even doctors make mistakes – don’t even get me started on the new residents in July. 

We are all in this crazy nursing world together and we all need to try to support each other. Whatever mistake you just made, I can promise you hundreds or thousands of nurses before you have made that mistake.

Even your management expects you to make mistakes. Don’t lie about it, take responsibility, make sure the patient is safe, and learn from it. That’s what your manager cares about. Really, as long as you weren’t deliberately doing something wrong or being blatantly negligent, you are not likely to get fired for it. 

Just make sure you aren’t making a habit of making the same mistakes.

On your hardest shifts and with your most difficult patients, it can help to have a positive personal mantra to steady yourself. Read my post with over 20 personal mantras to get you through your most difficult shifts.

2. Learn From It

Ever since my physical assessment final in nursing school when I forgot to ask when the last bowel movement was, I now ask it all the time. Every patient, every day, my husband, random people at UPS. You better watch out unless you want to share your bowel habits with me, too.

What I am really trying to say is that since I made that mistake, I am much more cognizant about making sure I don’t do it again. I learned from the mistake. 

There are tons of other examples of mistakes that I have learned from. For example, making sure that my patients have their call light before I leave the room. It is not a good look having your patient scream for attention when they don’t have their call light. 

The only true mistakes we make are the ones we don’t learn from. I know that sounds super cliche, and it kind of is. But it is also so true.

Just like a fresh 21 year old learning first-hand the mistake of mixing cheap liquor, sugar, and caffeine, fresh nurses sometimes need to learn certain lessons for themselves.

As a new nurse, there is still so much you need to learn. Even myself as a relatively new nurse with only three and a half years of experience, I have tons to learn still. Part of becoming an amazing, experienced, and well-rounded nurse is making mistakes.

As you gain more experience as a nurse, you will develop your nursing instinct. This is that gut feeling that tells you when something just doesn’t feel right. You likely already have this gut feeling, but you don’t have the confidence to trust it… yet.

That confidence will come with experience and time. Trust me on that.

If you want to improve your confidence in your nursing skills, read my other post on how to improve at any nursing skill!

3. Report It

I am not sure what incident reporting system your hospital uses, because there are roughly 4 bajillion different ones – I have used like 5 different ones since becoming a nurse. Whatever reporting system your hospital uses, use it. It’s there for a good reason.

These systems are not used to penalize, but to track data and make sure there isn’t an issue with the process/policy that is allowing these mistakes to happen. 

Like I said earlier, whatever you possibly did, other nurses have done it before you. That’s why it is so important to report the incident if appropriate. These report systems are used to see the swiss cheese holes in the process. Remember the “swiss cheese” model for safety incidents from nursing school?

Filling out an incident report can also help protect you and your license by making sure that the incident is fully documented. This documentation also allows your management to follow up with you and the patient as necessary. 

It allows management to do service recovery on the patient if it becomes something they are really upset about. This service recovery hopefully helps the patient feel better and more comfortable during their hospital stay.

I am not saying that every mistake needs to have an incident report. If you forgot to chart your I/Os every 4 hours, you probably don’t need to fill out a report – just fix your documentation. If you accidentally stick yourself with a used needle – yes, definitely report it. 

If you aren’t sure if you should fill out an incident report, run it by your charge nurse. 

I actually had my first accidental needle stick three years into my nursing career. I felt so stupid. After countless times giving injections, how could I have poked myself this time?! I filled out the appropriate paperwork, drew the patient’s labs for the needle stick work up and I filled out an incident report. 

Reporting this incident actually helped show that despite using the safety guard after the injection, the safety on this particular medication was a little confusing and easy to bypass. Because of my report, my facility actually switched manufacturers for this medication to one that had a better safety needle for this injection.

Filling out the report also helped me tell my coworkers about it and they were all so kind about it. Telling me about the times they had accidental needle sticks, or how they also thought the safety guard on that medication was weird. I felt way better about the whole situation after that.

4. Talk About It

There is something that Brené Brown says that I wish I could broadcast to everyone in the world, “Don’t bury shame, share it.” If we try to repress these feelings and these mistakes, then we just let them fester inside.

Brown describes that if we share our shame, it takes the power away from the shame and guilt and allows us to grow from it. 

Please, talk to your charge nurse, talk to your work bestie, talk to your preceptor, talk to me. It doesn’t matter, just find another nurse that you trust to talk to about your mistake. I will stress to talk to another nurse, because if you haven’t learned already, non-healthcare people just don’t get it. 

Last time I tried to talk about something nursey with my husband, he literally almost fainted in the middle of the grocery store, and then had to lie on the ground for 15 minutes – yes, still at the grocery store.

Not only is sharing your mistakes good for you, but it is also good for other nurses. No nurse is an island, we are all connected and we can all learn from each other. 

If you are able to share your mistakes and experience with other nurses then you are able to help them learn through you. Hopefully you have coworkers that you feel comfortable enough with to be able to discuss these things. 

They will be able to give you encouragement and could give you insight on how to avoid the mistake in the future. Having other people to discuss mistakes with is so important for really figuring out what happened and how to fix it.

There will also come a day when you are the one sharing your knowledge and wisdom to new nurses. I remember a shift on the floor when something happened, and I was like, “I need an experienced nurse!!” And then I realized, “Oh gosh, I am the experienced nurse.” 

If you’re a new nurse, it may feel like this day will never come, but trust me, it will come faster than you might think! And you can handle it!

5. Forgive Yourself

 

If one of your friends or a coworker told you about making a mistake, would you make them feel bad about it? No, of course not. You would encourage them and tell them that they are still a good nurse despite making mistakes. 

So, why do you think it’s ok to beat yourself up over it? We are all guilty of this, because we are all the most critical of ourselves. 

Give yourself the grace to be human.

Allow yourself to make mistakes and to move on from them. Making a mistake doesn’t make you a bad nurse. You are learning. Always. And you are getting a little bit better every day. Remember that. 

Especially as a new nurse, people expect you to make some mistakes. As long as you are not being malicious or negligent, making mistakes kind of goes with the territory. Allow yourself to be new at nursing.

Burnout is a real thing, and it can happen to any nurse. It can happen at any point in your career – even for new nurses! 

If you have a hard time bouncing back after your shifts read my other post with a new tool from renowned psychiatrist, Dr. Heim, to prevent burnout.

Have the humility to know that you aren’t perfect and the wisdom to know that you aren’t supposed to be.

Like I’ve said before, as long as you are moving forward, then you are winning!

Yes, we as nurses should try to keep our patients safe at all costs and try not to make mistakes, but even the best nurses occasionally make mistakes.

Sharing my mistakes with you has felt kind of vulnerable putting it out there on the internet. But learning from mistakes is such an important lesson that I wanted to practice what I preach and put them in this post. 

I hope you know that you are an amazing nurse. If you are on this website, then that means you are trying to improve, learn, and grow. That’s huge and such a testament to how amazing of a nurse you already are. Your commitment to the nursing profession astounds me.

Thank you for joining me on this journey. I hope I’ve helped you in some way. If I have, please consider sharing my blog with your fellow nurses!

As always, I would love to connect with you on social!

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