Approximately 10% of all deaths in the U.S. are due to medical errors making it the THIRD highest cause of death in America. The numbers are shocking, but actually under-reported and still add up to over 250,000 death per year. As a new nurse, you will make mistakes, but you can limit these by learning from and avoiding the same mistakes other nurses have made. The list I’ve compiled below includes ten common mistakes I’ve found, heard of, or maybe even made myself.
1. Not scanning/rate verifying a patient’s drips at shift hand-off or after a transfer. This should be done any time you take over care of a patient. Just looking at the IV pump isn’t enough. Actually, scan the patient and medication, check the rate and concentration, and document. This may require a dual sign-off for some meds, so do it with the off-going nurse or pull someone into the room. You’ll cover yourself from someone else’s mistakes and ensure your patient is safely receiving their medication. You’d be surprised how often your patient may be getting the wrong dose or no medication at all and it is better to catch this early than 2 hours into your shift.
2. Charting intake or output incorrectly. Monitoring fluid balance is vital for many patients. Be careful when documenting intake and output to use the correct column/row. Multiple drains, tube feeds, urine output, etc. can make this more complicated so don’t rush your charting.
3. Sending a patient home with an IV in. Check your patient over before discharging them to make sure they don’t have any peripheral IVs, central lines, or pacer wires they shouldn’t have. You don’t want to find out that you sent a patient home with something still inside of them and they had to come back in to get it removed.
4. Not having the chair and bed alarms on for a high fall risk patient. I work on a unit where all patients are considered fall risks, so every patient should have chair or bed alarms on. You may not be on a unit like this, but if your patient is a high fall risk or has a history of falls, put the alarms on! Almost all falls are preventable, so we must do our best to prevent them.
5. Making promises to patients you may or may not be able to keep. Just don’t make promises. Period. You will be asked so many questions from your patients and their families, but so much is out of your control that it is best to not commit or make promises. “We’ll see” or “I’ll keep you updated” might become your catchphrase
6. Leaving IV tubing clamped after hanging a medication. After setting up an infusion, check the IV lines before walking away. You don’t want to walk back in 30 minutes later and realize the tubing was clamped the whole time. Or it goes unnoticed and your patient just completely missed a dose. To piggyback (see what I did there) off of this point, make sure you reconstitute a bag of IV medication if it requires it.
7. Pushing a medication too quickly. If you don’t already know, ask someone on your unit to show you where to locate IV push rates. You’ll eventually remember most of the common ones, but until then you should know where to look them up. I frequently use Micromedex to look up medications if I’m not sure about something, especially IV push rates.
8. Being afraid to delegate. If nurses could do it all, we wouldn’t have CNAs, PCTs, or unit secretaries. You might feel that you have to prove yourself as a new nurse by not asking for help, but this is a huge mistake. Get to know your techs, secretaries, and other nurses well because when things get hectic they’ll be there to help you out.
9. Not asking questions. I highly doubt by the end of your orientation or even first year you’ll know everything there possibly is to know about nursing. If you’re unsure of yourself or how to do something, first do some research and if you still have questions, just ask! Find your charge nurse or a more experienced nurse and let them teach you. When you’re a new grad, you should be learning something new every day and if you aren’t seeking new things to learn, you’re losing out!
Hopefully, you’ll be able to avoid some of these same mistakes in your practice as you begin your nursing career. One piece of advice I would want to give every new grad nurse is to not go around in fear that you’ll mess something up. You have to be confident and calm! Slow is smooth and smooth is fast, so take your time and don’t let your busy shift sway your focus.