Eight Rookie Nursing Mistakes You’ll Do Once and You’ll Never Do Again.
Oh boy this is a good one. The word mistake may be a little harsh, we’re not really talking about something you are really doing wrong. There are a hundred ways to do things sometimes. Potential mistakes to avoid, ways to save your time, or avoid a mess is what we’re talking about today. I am personally the type of person to avoid a path well traveled with hazards if someone tries to give me fair warning about it. I don’t need to necessarily find out for myself that there is a pit of alligators or a single line rope over hot lava to make it to the end of my shift. If a nurse has been there, done that and cares to share a thang or two - I will definitely heed the warning. We have all been there, I have rassled lots of hypothetical alligators and shimmied meticulously across that lava pit but the point is, if you had a warning, wouldn’t you try to use the information to your advantage?! Well here is your fair warning.
Not Check the Allergies - Certain allergies should stand out to you at work depending on your specialty. Food allergies, Latex, Antibiotics and Opioids specifically stand out to me. You definitely don’t want to accidentally give the patient something they’re allergic to. Yes the pharmacy catches most medications ordered if the allergy is there, but what if the patient is allergic to nuts or Latex. The nurse needs to be aware and prevent potential situations where the patient is exposed. For example, Latex is everywhere, often made in straight catheter kits in the red rubber tubing of the catheters. Yes you are using Latex free gloves with the patient maybe but the catheter itself is causing moderate to severe redness, irritation or pain for the patient. Is that something you would pick up on?! As potentially being caused by the latex in the catheters. Are you notifying the doctor, going to go to central supply and trying to order latex free catheters for the patient as well?! Yes, we should be.
Allow your IV tubing to run dry - It’s just extra work for you most of the time. When you set up your IV tubing always grab a flush bag of saline to set up with it. Unless of course the medication is contraindicated. This will save you and the nurse coming behind you some time. Sometimes it is also unavoidable. Although you're not perfect, I could definitely add up the time spent re-priming tubing or trying to get air bubbles out in a shift and assign that time to another more important task. You need to set the pump exactly so it works in your favor. Educate yourself and ask for troubleshooting tips from other nurses on your floor too. Don’t waste extra time though.
Allow your patient to cough while giving a G tube medication or feeding without clamping the tube - Now I’m not sure why I or no one seems to think of this beforehand but when the patient coughs and the g tube is not clamped, all the contents of the stomach and syringe get pushed up with the pressure of the abdomen contracting with the cough and shoot out the top of the syringe like a volcano. Ha ha, I can picture it now and it has happened one good time to me. I really cant believe I didn’t see that coming but I catch it every time now. Maybe we get so stuck on making sure everything else is right, we don’t always think of that one at first. You have to be quick with it lol twinkle fingers. Also don’t forget to make sure the head of bed is up during the feed or medications, then still up for a few minutes after you are done. Patients may vomit sometimes and are at high risk for aspiration. Then you, as the nurse, are dealing with a bunch of other things once that happens, avoid it at all costs, then handle like a pro if it happens.
Get too close to an agitated unpredictable patient - You will definitely see your fair share of behaviors with patients in your nursing career and I hope you have good nurses around you to show you in real time how to deal with this. There is no better teacher than personal experience. We often as nurses receive the brunt of the patients agitation for reasons out of our control. It is still our responsibility to keep the patient safe. Patients will yell and fight with you until the cows come home but think about the task at hand, how to give it your best effort, document accordingly but the patient can also refuse. Do not spend unnecessary time or energy on engagement of behaviors. Give your effort to redirecting the patient, explain the situation, educate within your scope, educate what you can do, then if the patient continues with negative behaviors then kick it up the chain of command. Again, Do NOT give high energy people more high energy. You want to keep your distance when the patient is agitated, you don’t want to get too close or turn your back on the patient if they're in a high state of agitation. Practice de-escalation techniques to calm and gain control of a situation early on. Try to prevent it from escalating. They offer education at my job occasionally on this topic and if it ever comes across your desk I would advise jumping on an opportunity to learn these coveted skills. You need to know what resources you have, do you have other nurses who can help, a male coworker perhaps, security, prn medications to give etc?! Get a plan in order from the beginning for how the rest of your shift is going to go and how you are going to handle that patient. If you are interested in talking with me more specifically about a situation or case study feel free to send me an email at firstname.lastname@example.org
Visually check your insulin while drawing it up - Get in the habit of doing a double or triple check of your insulin when you draw it up. When I was first starting out I would question myself and need to redraw the medication just to be certain I was giving the right dose. No, that’s a waste of time. If you get in the habit early when you second guess yourself you also have the thought of confidence knowing you already did an extra step. You will think, I already did the quality control and the double check when I was drawing up the medication.
Double Glove for Code Brown - Code Brown as you can imagine is another name for a poop clean up assist. And I’m just telling you, it helps to double glove, maybe triple glove at the door before you even get started. That way if by chance your glove gets soiled you can quickly remove it and already have a fresh one underneath. I learned this one from a CNA, thanks girl!
Accidental Needle Sticks - Be careful with needles. Periodt!
Overfill a Urinal or Graduate to make one trip to empty to the toilet - Do not do this. It’s not necessary, just make an extra trip. Ugh, it always spills! Even if you walk slowly and are extra careful. I hate what that happens.
Let me know on Instagram what you would add to this list and Good Luck! 😉