You are a new nurse, just six months off of orientation, working on a busy surgery unit. It is evening shift and one of your patients has a heart medication scheduled for 5 pm. You go into the room to pass the med and the patient asks you if you can simply wait until she has finished eating dinner. Sure, why not. That is an easy request.
Until you get a phone call at 2 am. It is your unit calling. The charge nurse informs you that the nurse who followed you found the heart pills at the patient’s bedside- untouched. Freaking out, you ask how the patient is doing and what is happening at work.
They tell you that everything is fine. And even though nothing bad happened… you just did the one thing you have always dreaded as a nurse. You make a nursing mistake!
On the Verge of Making a Mistake
This article was stimulated by the very fact that on a daily basis nurses are on the verge of making mistakes at work. There are the errors that we know about and then there are those we make without even realizing it. No matter how big or small, to make a mistake in nursing… it can be devastating!
Overwhelming stress, heavy patient loads, constant alarms, and demanding charting systems increase the chances for making an error. Nurses have to rush from patient to patient, doing more with less, and often do not have the time to think about what they are going to do next.
Do Something About Nursing Mistakes
What can be done? How can we help nurses who are on the verge of making mistakes in nursing?
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Mindfulness seems to be everywhere these days. I actually found out about it myself in 2010 after reading the book, Full Catastrophe Living, by Jon Kabat-Zinn. In this article Kabat-Zinn defines mindfulness in this way. “Mindfulness is awareness that arises through paying attention, on purpose, in the present moment, non-judgementally,” He says: “It’s about knowing what is on your mind.”
Now, before you stop reading, let’s break this down and apply it to our work as nurses. You might be thinking, “Well, I have to go to some retreat to learn about this mindfulness stuff and how to actually do it.” You are right. You certainly can do that. Although, it is not necessary.
We have one tool at our fingertips that can help us to be more present. It is called the breath.
Every moment of every day you are breathing. Well, at least when you are alive. Anyway, when you breathe you can use this opportunity to slow down and come present to your work. I actually recommend nurses do practice paying attention to their breath outside of the workplace. Why? The more we do this in the quiet (e.g. in our car, in the shower, or in bed)… the more likely we are able to tap into this practice in the chaos of our nursing careers.
The more you can focus on the breath outside of work- the more you can use this practice while at work. And then, when you are in a very busy, distracting situation you can slow down. Feel your feet on the floor. Pause for a couple of seconds and take a breath in and out of your nose. There- you’re done. And doing this in the busyness of your nursing career can help you avoid making that nursing mistake.
2. Do One Thing at a Time
I know, I know. Before you throw syringes and stethoscopes at me- hear me out. When we multitask, we actually do not fully pay attention. To anything.
Multitasking drains our energy and makes us less productive. Additionally, according to Earl Miller, a neuroscientist at MIT in Cambridge, Massachusetts, multitasking “wastes time and increases the chances of making mistakes.” I don’t know about you… but I do not want to waste time. And I definitely do not want to make a nursing mistake!
So what can be done? Now, I know that this sounds difficult. And it will feel counterproductive. Especially when we as nurses have SO much to get done. But we need to try.
Try to do one thing at a time as much as possible. Attempt to role model this behavior by letting people know when we are busy with a task and not to be interrupted. Focusing on the task, decision, or patient in front of us before quickly (or at the same exact time) moving on to the next.
3. Support Colleagues in Safety
Building upon strategy two above regarding multitasking, we need to support each other with decreasing the likelihood for nursing mistakes.
I once heard of a nursing unit that piloted a “medication distraction vest”. They literally created a bright red vest that the nurse would wear when he or she was pulling medications from the pyxis machine. In this pilot project, they decreased errors and increased staff satisfaction.
We need to speak up for ourselves and our nursing colleagues at work. If we see a problem with interruptions or distractions where we work, instead of complaining about it, we need to join the committee or council working on this issue. Bring innovative solutions to your team. Network with other nurses and ask them how they have handled this problem in their workplace. Be that nurse that brings new ideas to the job.
4. Bonus Strategy: The Art of Nursing program will cover distractions and how interruptions in the workplace threaten patient safety. Jeanne Venella, DNP, MS, RN, CEN, CPEN, Chief Nursing Officer for Bernoulli, will:
Review the current state of alarms and the impact on nursing practice, safety and quality, clinical outcomes, patient experience, and staff satisfaction
Discuss regulatory guidance on managing alarms pertaining to The Joint Commission, ECRI, and AAMI
Identify strategies for alarm reduction
Let’s hear from you! Have you ever made a nursing mistake? What did you do about it? Share a comment below on how nurses can avoid nursing mistakes, and thank you for reading.
About the Author: Keynote speaker and virtual conference host, Elizabeth Scala MSN/MBA, RN, partners with hospitals, nursing schools, and nurse associations to transform the field of nursing from the inside out. As the bestselling author of ‘Nursing from Within’, Elizabeth guides nurses and nursing students to a change in perspective, helping them make the inner shift needed to better maneuver the sometimes challenging realities of being a caregiver. Elizabeth received her dual master’s degree from Johns Hopkins University. She is also a certified coach and Reiki Master Teacher. Elizabeth lives in Maryland with her supportive husband and playful pit bull.