Nonetheless, nurses, no matter how logical they might think and act, are simply human beings who are capable of committing certain errors every once in a while. In the local scene, our nurses seem to be more exposed than ever to certain mistakes due to extended hours of shift, heavier workloads, and replacement of experienced nurses by newly-trained and inexperienced young ones. With this in mind, Filipino nurses, especially the newbies, should always remember to always avoid miscalculations and mistakes.
And to better equip my fellow nurses with the knowledge they need to avoid such incidents, here are the 5 common nursing mistakes and foolproof tips on how to avoid them:
1. Medication Errors
Dispensing wrong medication, dispensing wrong dose of medication, giving a medication to the wrong patient, and failing to monitor patient’s condition are some of the errors under this category that are potentially life-threatening to patients. No one is excused to this kind of pitfall; you can either be a new nurse or a staff nurse with years of experience and still commit this awful mistake. For student nurses, common causes are lack of “presence of mind” , extreme pressure, and fear of their clinical instructors that will provide a barrier which will make open communication and learning between them impossible. Experienced nurses, on the other hand, usually commit mistakes due to overfatigue. According to a 2004 report in the journal of Health Affairs, the occurrence of nursing mistakes are three times higher after a shift has extended past 12.5 hours. I hope this will serve as a simple reminder for hospitals currently exploiting nurses.
How to Avoid: The moment you enter the hospital premises, you have to leave your ego behind, forget any personal/family problems that you have and deal with it later after your shift, and always have a presence of mind. Deal with your patients as if they are one of your loved ones and of course, don’t ever forget the 10 GOLDEN RULES/RIGHTS IN MEDICATION ADMINISTRATION. Remember, as a nurse, it’s a crime and a potential source of negligence to forget this essential information.
2. Patient Falls
Patient falls often occur when patients attempt to get up on their own to use the bathroom or pick up something out of reach. They commonly occur in patients without any relatives around to assist or attend to their needs. This might cause injuries or even death to patients if measures to avoid it are not strictly followed.
How to Avoid: Do nursing rounds to patients (especially those who are high-risk for falls) hourly during the day or every two hours at night, make sure personal belongings and things that are essential to patient are within his/her reach, follow safety procedures (e.g. raising side rails), and let patients know that you are always ready to help in case they need assistance from you.
I remember one time when our group was assigned in the medical ward of a public hospital, we encountered a morbidly obese stroke patient who suffered from a severe type of infected bed sores. What was appalling was the fact that her relatives were always by her side at that time and the incident could have been prevented had the attending nurse, who was obviously busy, taught the relatives how to perform basic skin care and turning. I t will never be an excuse to say that infections can NORMALLY be found in the hospitals because we are agents of health and we have to uplift patient’s condition at all times.
How to Avoid: Never underestimate the power of hand hygiene and using techniques to avoid occurence of infections. Nurses should remember that iatrogenic infections are caused by nurses’ negligence most of the time.
4. Documentation/Charting Errors
Admit it. Your experience as a nurse will never predict if you will not commit documentation errors or not during the span of your career. Recording information in your patient’s chart is an important part of your job as a nurse. There are many ways that charting mistakes can be made. By making yourself more aware of these eight common pitfalls, you can not only avoid making these mistakes but you can also avoid being involved in a lawsuit.
a. FAILING TO RECORD PERTINENT HEALTH OR DRUG INFORMATION
b. FAILING TO RECORD NURSING ACTIONS
c. FAILING TO RECORD THAT MEDICATIONS HAVE BEEN GIVEN
d. RECORDING ON THE WRONG CHART
e. FAILING TO DOCUMENT A DISCONTINUED MEDICATION
f. FAILING TO RECORD DRUG REACTIONS OR CHANGES IN THE PATIENT’S CONDITION
g. TRANSCRIBING ORDERS IMPROPERLY OR TRANSCRIBING IMPROPER ORDERS
h. WRITING ILLEGIBLE OR INCOMPLETE RECORDS
How to avoid: Never stop learning. When in doubt, always ask your seniors or other staff nurses who are more experienced than you are. Always remember the basic reminder that says “Nursing procedure not charted is a nursing procedure not done“. Read books like “Documentation in Action” by Lippincott Williams & Wilkins ed 2006 to familiarize yourself more with the basics of documentation.
5. Treating Nursing as a “JOB”
Wondering why I included this on the list? Because none of the reminders I just mentioned will be effective if YOU don’t love what you’re doing. I know a lot of nursing graduates who were either forced to took up Nursing or took the course because of the promise for a better life abroad. These are the same people who take Nursing as a job and not as a vocation. In the long run, these people might commit fatal errors because they are not keen to details, don’t really love what they do, and always excited to go home and curse every second they spend caring for their patients.
I hope you will keep all the information I have shared deep into your hearts and minds. Remember, we are handling lives so we should always try to keep the words “mistake” and “error” out of our vocabulary.