Everyone makes mistakes. 

Maybe you misplaced your work lunch, forgot to grab that patient a warm blanket, or didn’t have time to update the whiteboard.

While some mistakes are just part of being human, other mistakes, like miscommunications or medication errors, can cause serious harm. Bedside nurses are under tremendous pressure to perform interventions, prioritize endless tasks, and brief interdisciplinary teams (and patient family members), leading to unintentional mistakes.

Although mistakes are bound to happen, understanding how they occur, creating a safe culture around reporting, and implementing safeguards can improve patient care and support nurses.

Common Causes of Nursing Medical Errors

Medical errors are recognized as the third-leading cause of death in the United States, but how do they happen?

Medical errors in nursing often stem from systemic issues rather than a nurse’s negligence. 

These causes include:

• Communication breakdowns
  Example: The doctor said 15, but the nurse heard 50. The nurse put the verbal order in the computer because the doctor was busy rounding.

• Fatigue and understaffing
  Example: An offgoing nurse had to give report on six patients, so she mixed up a few data points from two patients with similar conditions.

• Medication errors
  Example: The nurse pulled hydralazine from the Pyxis instead of hydroxyzine. 

• Documentation mistakes 
  Example: The nurse scanned a patient’s Q4 Norco at 1400, but got pulled away and didn’t administer it until 1500. At 1800, the patient asks for another dose.

Impact on Patients

Depending on the error, patients, or other healthcare professionals, can face consequences like:

• Adverse drug reactions

• Extended hospital stays

• Hospital-acquired infections, like MRSA or pneumonia

• Loss of trust in healthcare, or colleagues and coworkers

Preventing Medical Errors Through Just Culture

Most mistakes aren’t malicious, and every nurse will make some type of mistake at some point in their career. Creating a Just Culture, which promotes accountability and learning over punishment, encourages open reporting and fosters a constructive environment for nurses.

Just Culture starts with each individual nurse. Try to:

• Be kind. If you notice or hear about a fellow nurse making a mistake, treat them how you would want to be treated. Strive to understand how they made the mistake.

• Lead by example. If you make a mistake, report it through the proper channels so others can see that reporting is the first step to change. 

• Advocate for system improvements. Take note of what mistakes are being made in your unit. Bring your ideas and solutions to unit council meetings and discuss them with your leadership. Certain technology, checklists, or reporting tools that you advocate for could make a true difference. 

By fostering an environment where nurses can report concerns without retaliation, Just Culture helps prevent errors before they escalate.

Final Thoughts

Preventing medical errors requires a team effort, with hospitals supporting nurses through better systems. As a nurse, you can be part of a Just Culture that encourages open reporting, innovation, and safety in your unit. 

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