By Christina Proctor, R.N.
The challenges in the nursing work place can be truly overwhelming. Patient-to-nurse ratios, understaffing, emergency situations, and the sheer volume of tasks you are responsible for are enough for you to manage. Add in other challenges like difficult coworkers, not having needed supplies, and your own rising fatigue and stress levels, and you have the groundwork for mistakes that could result in injury or even death.
In my 15 years as a Registered Nurse, I have experienced many challenges to keeping myself and those I care for safe. I have definitely learned some things along the way, including those from my own mistakes and those of others. The following are some techniques to help you be ready for those days when you feel like you are working in catch-up mode for 8-12 hours or more.
Refuse to Rush
Recognize the difference between acting with purposeful speed (like running to a code) and rushing with a sense of not having control. It may be difficult to stay calm when there are so many things you need to do, but it really does take more time to fix a mistake than it does to make sure you are being careful in your nursing practice. Get in the habit of rechecking a patient’s name before saving your documentation and rechecking meds before you give them. Staying purposeful in your actions also contributes to a sense of control, even in the most demanding of days.
Document the Details
Completing all your necessary documentation may not be possible for several hours. It’s helpful to jot down abnormal patient assessment findings like edema, cough details, and lung sounds on paper (with your red pen) to document later, rather than trying to remember any abnormal findings. In addition, I have found it very helpful to try to document notes in real time every couple hours (or per your company policy) with details that will help me remember the patient later. Keep in the back of your mind that if you ever have to be in court trying to recall this patient, what will help you remember them? Re-reading notes that say “No changes”, “No c/o”, “Patient resting with eyes closed, resps even and unlabored” will do little to help you remember. Charting even innocuous details will help you recall the patient later if needed, and will help you maintain your sense of control during busy shifts.
As a new nurse, perhaps the sting of error hasn’t happened yet. As a seasoned nurse, many tasks have been performed a countless number of times. It can be so easy to grab the wrong insulin pen, or mix up sound-alike names of patients or medications. Remember that mistakes happen to everyone and the results can cause great harm.
As nurses, we have the responsibility to keep ourselves and our patients safe. Many factors can make doing this a challenge, but cultivating good habits will help ensure that safety is not compromised even under the most stressful shifts. Refusing to rush, documenting details particular to each patient, and avoiding overconfidence are a few ways we can maintain safety in our busy work environments.
Christina Proctor is a full-time Registered Nurse with more than 15 years of experience. She currently works at Columbia Memorial Hospital in the Saint Paul, MN area.