Making Sense of the Mistakes

Even the most seasoned emergency nurse will sometimes encounter an unexpected outcome. But emergency nurses can increase patient safety by openly debriefing and problem-solving when patient care does not go as planned.

“Historically, we have been afraid of retribution or disappointment from our peers, so many nurses have kept their ‘mistakes’ to themselves,” said Teri Campbell, a flight nurse who presented “Trials and Tribulations of Terrible Tot Transports and Take-Away Tidbits” on Friday. “If we do not have a brave enough voice to debrief and learn with our peers, then we are setting ourselves and our patients up for future mistakes.”

Campbell’s case-based lecture focused on pediatrics, highlighted transports that did not go as planned and detailed how nurses can learn from mistakes. With humor and empathy, she explained what went wrong. She reviewed questions that keep her up at night and explained the lessons she learned from each case.

She said missteps can happen for a variety of reasons.

“Sometimes, it is because we receive patients who were mismanaged prior to our arrival,” she said. “Sometimes, it is because the patient deteriorated and we did not recognize it right away.  Sometimes, it is because something deleterious occurred that was out of our control and we needed to recognize and immediately intervene to mitigate or prevent poor outcomes.”

Campbell said it is up to emergency nurses to make sense of the mistakes so they aren’t repeated in the future.

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