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As a healthcare worker, making a mistake in your career is inevitable. Right now, in the United States, the media is focused on a nurse’s responsibility for medical errors. Many nurses are left wondering, “Who’s got my back?”
Working as a nurse comes with a tremendous amount of personal responsibility and public trust. According to the Gallup Poll, the nursing profession ranked the number one most trusted profession for two decades. Over the last couple of years, nurses have been called heroes or angels. Being placed on a pedestal feels incredible when things are going well. The unintended consequence of putting hero status on nurses is that it can feel like a moral injury when mistakes are made.
An NIH study found that medication errors, the most common medical mistake —and often the most deadly— went grossly underreported. The most significant barriers to not reporting were the perception of personal failure (rather than system failure), fear of repercussion, and fear of professional consequences. Healthcare leaders recognize that punishing healthcare workers for mistakes does not create a safer work environment. Punitive measures for reporting medical errors result in poorer patient and worker outcomes.
So, how do you move forward when you’ve made a mistake?
1. Know how your facility handles reporting
Owning up to a mistake can feel scary, and there’s no question some workplaces handle reporting better than others. Before accepting a position, ask your prospective employers how they handle medical errors. Put your advocacy skills to use for yourself. Knowing these details ahead of time can help you sense workplace culture and employee support.
2. Know how you will handle reporting
Knowing that making mistakes is part of our human condition and the chance of making mistakes exists, you can calmly assess the situation and think, “I’ve made a mistake. Now what?”
The number one answer is to report it. As soon as you realize a mistake has been made, it’s your top priority to report it. The faster the error is addressed, the more likely it can be fixed and lead to a better outcome. This is especially important when patient safety is involved.
Treat small and big mistakes with the same level of importance. Maybe the mistake you made was small. Perhaps a Tylenol 500 was dispensed instead of a Tylenol 250. No big deal, right? It might not be a big deal this time, but what might happen with an unfamiliar medication with more severe side effects? Treating the big and small mistakes with the same level of importance gets you in the habit of recognizing your humanity, owning up to it, and walking with integrity.
3. Know where to turn for support
You’ve reported your mistake. Now what? Anxiety, shame, and guilt nag in the background. You keep replaying it, thinking, “I’m such an idiot. I hope nobody finds out.”
Treat yourself with compassion. If you get stuck in shame, try to make a shift to curiosity. Ask yourself questions like, “How can I use what happened as a powerful learning opportunity?”
Nurses are natural problem solvers. By changing self-judgment to curiosity, the brain shifts into detective mode. It allows for reflection on how things could go better next time. Taking this approach can create compassion for yourself and help you develop safer systems for the future.
Depending on the outcome of the mistake, you may want to explore professional support. Some facilities offer workers a chance to debrief or offer other mental health resources within the organization. You are a human with complex human emotions. Allow yourself the support available.
4. Know your deficits
Another question is, “What do I need moving forward?” Create a plan for yourself and try these tips for leaving pre-shift anxiety at the door. Maybe the mistake was made out of a knowledge gap. If so, what education needs to happen to fill the gap? Perhaps you’ve been working too much and not giving yourself time to decompress. What would it look like to use some vacation days? Take some time for self-reflection and course corrections. Creating an action plan demonstrates another level of personal responsibility and integrity. Taking these steps is an important part of self-forgiveness.
With the high level of professional expectations placed on nurses, it’s no wonder they feel increased anxiety, guilt, and shame amid a mistake. Knowing how mistakes are handled within your workplace, and creating a plan for how you’ll respond personally and professionally, can help you cope successfully. If you’re feeling like you need a do-over, either mentally or physically, check out these 10 tips for resetting the mind and body that can benefit all healthcare professionals.
