Oh, $@#*%! 5 Steps to Take After Making a Medical Error

We’ve all been there…on the guilty end of making a mistake when it comes to caring for our patients. Whether you prescribed an antibiotic to which the patient was allergic, performed a less than adequate procedure or misdiagnosed a medical condition, nurse practitioners and physician assistants aren’t perfect. Mistakes are to be expected. We are, after all, human. But, when working with patients even the smallest of errors can have major consequences. What steps should you take when you totally screw up?

According to the Journal of Patient Safety, between 210,000 and 440,000 hospitalized patients each year suffer from some type of medical error that contributes to their death. That makes medical errors the third-leading cause of death in America, resulting in higher mortality than accidents or strokes. Many times, medical errors can be attributed to the systems and processes in place within the hospital or institution. Other times, negligence of the medical provider is to blame. Whatever the cause of the error, reacting appropriately is essential for the health outcome of affected patients and to ensure the best possible legal outcome for the provider

If you make a medical error as a nurse practitioner or physician assistant, here are the steps you must take in response. 

1. Admit the error

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Many healthcare providers assume that letting the patient and family know of a medical error puts them in a bind. Providers expect that patients may be unlikely to allow the practitioner to take steps to correct the error given apparent incompetence. And, healthcare providers predict that admitting a mistake could lead to a medical malpractice lawsuit. Data shows otherwise. 

A study from the University of Michigan indicates that the more upfront and honest healthcare providers are in the face of a medical error, the less likely patients and families are to reactively sue. So, if you make a mistake as a nurse practitioner or physician assistant, fess up. 

2. Fill your team members in

Errors must be communicated to the rest of the patient care team so that any necessary modifications to the care plan can be made. Admitting your mistake to colleagues isn’t easy. Failure to do so, however, can result in increasingly negative patient outcomes and mismanagement of the patient’s medical condition.

3. Report the mistake according to protocol

Your hospital likely has a protocol in place for reporting clinical errors. Let your supervisor know of the mistake and complete appropriate associated paperwork in a timely manner. Adhering strictly to reporting guidelines is essential. First, this alerts administrators to systems and protocols that may need to be modified to prevent similar errors in the future. Second, this shows your compliance helping keep you in good standing with your employer. Finally, adhering to protocol puts you in a better place legally should litigation arise as a result of the incident. 

4. Document, document, document

Documenting the events of the error in a timely manner is essential. Documentation must be accurate and complete including the date and time of the error, the location, a description of the incident, the severity, presumed cause or circumstances and the immediate actions taken in response. Keep documentation objective. Be thorough. This written record will be the basis by which your actions are judged as well as the background from which further care of the patient is dictated. 

5. Remain legally aware 

Facing a medical malpractice lawsuit is a nurse practitioner or physician assistant’s greatest fear. The process is nerve wracking, costly and potentially public. If you are later approached with questions regarding your error, or if your error is significant, seek legal counsel early on. This ensures you don’t make any errors in communication that could be used against you in future litigation. Staying on point legally isn’t adversarial, it’s simply smart. 

Have you ever made a mistake as a nurse practitioner or physician assistant? What were the implications?


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7 thoughts on “Oh, $@#*%! 5 Steps to Take After Making a Medical Error”

  1. I have never made an error or mistake. It is usually the dumbass nurses making the most mistakes. They could use more education in pharmacology. Most of the time they have no knowledge of the medication they are giving, dosages, or appropriate routes. I personally would rather have a staff of Paramedics.

  2. Renee Bourgeois MSN, BSN, and most of all RN

    Not impressed with prior comment, have you ever worked as a nurse and had the load they carry, obviously not. How dare you disrespect them in their positions of understaffed patient care. RN, BSN, MSN

  3. It takes a team working together to care for patients safely and effectively. Agreed that not all (MDs, PAs, NPs, RNs, Medics) are of the same caliber. I have had some of each group that I do not readily trust, but such sweeping generalizations are that of ignorance. You would be better served by directing the arrogance toward education.

  4. CT Physician Assistant

    Dear PA PA,

    Regardless of the credentials we have earned behind our name, we have all made mistakes. You are no exception. To believe otherwise is ignorant and obtuse. Furthermore, blaming the nurses you work with for errors in “appropriate dosages and routes” is simply shallow. Nurses, like any other healthcare professional, make mistakes. You are the prescribing practitioner and should know the appropriate pharmacology to order medications accurately. Acknowledging the errors of your co-workers is helpful when some positive action is taken to correct the problem. Simply blaming them is tactless and crude.

  5. Wow, that’s quite the statement PA PA! I’m one of those dumbass nurses you speak of and have never made a med error in the 11 years I’ve been an RN. I’m now a few semesters away from being an NP and I hope I never have to work with a PA as “superior” as you.

  6. “It is unwise to be too sure of one’s own wisdom. It is healthy to be reminded that the strongest might weaken and the wisest might err.”
    — Gandhi

  7. MSN, FNP-BC , BSN, RN

    PA PA, I have made a mistake….. and since I am a human being ( humans make errors often). One mistake I have never made is to be so confident in my self to say I have never made a mistake. Maybe you made a mistake that you also missed. I think your post is a mistake….. so you are perfect in everything you do?? well now that is extraordinary. Where do you get your super powers?? Remember after pride comes a fall. Please be humble and remember that everyone is fighting a tough battle so be kind.

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