As an ER nurse, as well as having worked as a paramedic, for the last 20 years I could never have made it without a sense of humor. A sick one at that. Sure there are times and things that I can't laugh at, there are many more that I can and will make a joke about. Political correctness and professional ethics be damned. And _____ them, if they can't take a joke. This is the way I deal with it.

On the serious side, I have found that having a tight network of friends (mostly ER staff, paramedics, and a few cops) that can relate to you when you need to vent is more valuable (to me anyway) that a formal "incident debriefing" or a shrink. What is invaluable to me is the support, and the shoulder to cry on I receive from my wife who is also an RN. Not everyone is as lucky as I am in that regard.

Re: ER nurses?
Hi Shannon! I am glad you want to do ER nursing. I think my best stress support next to my family is the staff I work with. Many times these are the people who see you at your worst and best of times. We work together all the time and we're kinda like a little family unit. We support each other in many situations, inside and outside work. I think anyone in a stressful job must have a hobby to take them 'away from it all' once in awhile. I myself love motorcycle riding and do it every chance I get, which is about 4 days a week. I know other nurses, paramedics, police officers, and a couple MDs, and we make sure to go on rides at lease 2X a month. Good luck in your career choice! :wink:

med errors
I have been a nurse for 12 years and have made a few med errors during that time. Fortunately, they did not have life-threatening consequences. However, I am devastated that they have occurred and now want to give up nursing.
Can anyone share with me how they have personally handled the embarrasment and shame they felt if it happened to them?

I agree with Spiffy about the sense of humor part. I'm always the one to make a smart comment in the middle of a code and make everybody smile. It seems to help everyone refocus as well. Also having someone you can talk to after hours is a big help to me. My girlfriend is also an RN in an ER, so she understands completely when I'm frustrated or just stressed. And I don't have to explain terminology and procedures to her like I do when I'm talking to my nonmedical friends. And if all else fails, hit the ATM and go shopping. That always makes me feel better.

i am not a "nurse " yet. i just do nursing home duties. I am thinking that because you feel bad about the mistakes, that seems to me , that keeps you as great nurse.
another thought. we are all human. we all make mistakes. yes, we shouldnt make them as a nurse. but i am thinking......it might happen from time to time.
my dad told me growing up, when you make a mistake,
think about what happened to lead up to that mistake. examine what could of been done differently. learn something from it. and if that situation comes again, have a plan in place to do it differently the next time.
and as hard as it is. admidt , hey, i made an error. NOW, what can we do about it to correct this thing. do what you can to fix what you can. then forgive yourself for being human. let it go. be prepared with that plan so you can not repeat that error again, if possible.
learning from our mistakes is great GROWING. we become better people because of it.
and the embarrasement is just a tool for us to know that we are human and we are to take steps to never repeat this kind of error again.
as we redeem ourselves by doing it correctly on a repeated basis. from here on out, the embarrasement will pass.
im getting close to when i will be a student nurse. wow, i am nervous because i dont want to make mistakes at all. but i realize i am not perfect yet. it takes practice. that is why they say doctors / nurses are "practicing " medicine. we arent perfect yet, nor will we ever be.
But what is done is done. ok, lets take it from now, with a clean slate. what can i do TODAY to do it correct and do my best. cuz we sure cant change the past. and as each day passes and i do it correct each hour and each day. we can feel better and know, hey, i did it right today. i feel good about today. and we need to be willing to ask for help when we need help. and go to the bathroom and cry when no one is looking. or talk to God about it. maybe he can be a help?
God bless, hope something i said could help.

First, cut yourself some slack. If you have only made a "few" med errors in a 12 year nursing career than you are doing a great job. I think of the thousands of meds I have given in my 25 years in this business, and if you have only made a mistake a few times, then your batting 99.9999999%. That's darn near perfection, and NONE OF US ARE PERFECT. Remember, baseball players are considered great if they make a hit in 1 out of 3 attempts at the plate. So don't be so hard on yourself.

Second, consider the significance of the error. Did you give the wrong med to the wrong patient? Was it at the wrong time? or was it the wrong dose or route? By the rules we were taught in nursing school, any of these could be an error, but are they really significant? For example, giving a med at 2 pm instead of 12 noon is an error, but is it really significant? Giving a med 4 hours apart instead of 6 hours apart is an error, but, once again, is it really significant?

Third, consider the potential for harm. I used to work for our local Poison Center, and I can tell you that the vast majority of calls we received (and we are talking about accidental overdoses or exposures to all kinds of substances) were unlikely to result in any significant harm. But as a practicing nurse, I can tell you that nurses are most likely to get into trouble if they make a mistake with IV meds, so all of us need to exercise extreme caution when giving anything IV.

Finally, as far as "dealing with the shame", you need to let go of expecting perfection from yourself. Admit your mistake, apologize to your peers, forgive yourself, and, if you are being disciplined, then accept your punishment and move on. Your life doesn't have to be defined by one mistake. And, honestly, I've always felt a great deal of compassion for my peers who are dealing with this issue. We all recognize that you feel bad about your mistake, but you don't have to hang on to the emotional baggage for the rest of your life.

My pastor recently gave a sermon on LEAVING ISSUES BEHIND, and it applies in this circumstance:

1. Let go of the baggage
2. Close that chapter. Your future is an opportunity to learn from your past mistakes and successes. It's time to quit dwelling on the things that used to be and close that chapter.
3. Quit talking about the past. As long as you keep talking about the things of the past, a victim's mentality will hold you back. It's a new day, and God is doing a new thing in you.
4. Let go of the shame. You can't let anything of your past cause you to put your life on hold. If you let go of the shame, God will help you build a new future.
5. Enjoy today.
6. Walk by faith and not by sight.
7. Understand the power of forgiveness.

If you have made an error where a patient may be harmed, you have to own up to it. The only way we can fix the problem is to acknowlege it and take corrective action. This is the one thing that needs to be changed in this profession. We need to make it safe for nurses to admit their mistakes. This can only happen if we create an environment that acknowledges that all of us are imperfect and it could be any one of us who makes that critical mistake.

medication mistakes.
Sorry I can't agree with you guys on that one. All it takes is ONE error to cause problems for your patient, or even death. ALWAYS do the "five rights" of medication administration, and you will not mess up. A nurse in Houston gave my son an IV abx that he had listed as an allergy, and he swelled up big time. Then it took her 20 minutes to get the benadryl! Yes, you learn from your mistakes but you are not in field that allows for them.

I will tell you that mistakes cannot be corrected unless we own up to them. Many of the big mistakes I've seen in my career aren't always the result of one bad nurse. They are caused by many problems with the system, and the system can't be fixed if we don't acknowledge the problem. Any one of us could repeat the same mistake because we didn't fix the underlying cause.

For example, about 10 years ago, a nurse in a hospital that I worked for accidently picked up a Potassium vial instead of a Saline vial and flushed a hep lock with it. The patient died. Of course, that nurse suffered the consequences for her mistake (fired, faced disciplinary action from the Board of Nursing, plus had to live with the guilt of her mistake). But back then, it was pretty common practice to store those vials (along with heparin flushes) in the same area in the med room. However the only reason you need potassium vials is to mix it in an IV bag to give in a drip. So, why in heaven's name were we storing these things in the med room with these other vials? Don't you think that's a dangerous practice? And how can you single out one nurse for making that mistake?

Since that time, it's now a JCAH regulation that potassium vials cannot be stored in the med room with other vials. I've been in a number of places since that year, and NOBODY stores potassium vials on the floor anymore. It's mixed by the pharmacy. But one nurse had to take the fall in order for the system to change. And, for me, that's a tragedy that could have been prevented all those years ago if we just got off the blame game. All of us need to work in an environment that allows us to practice as safely as possible. Leaving potassium vials lying around was sloppy practice by the hospital, but back then, everybody did it.