I read the following case study online; although I have shortened it considerably, here is the gist of it:
“I made the worst medication error today and feel horrible about it. I want to quit from sadness and embarrassment. I’ve been a nurse for about 10 months. I have been working at the hospital for only about 5 months.
“I had a patient on a lasix drip that was 100 mL total volume: 100 mg in 90 mL, calculated to be given 5 mL/hr. To make a long story short, I infused the medication at 100 mL/hr instead of 5 mL/hr. I was looking at the 100 mg in 90 mL and I was also looking at the 100 mL total volume instead of paying attention to the 5 mL/hr. The charge nurse and I caught the error but the patient already had received 75 mL in a little over 3 hours; it should have been almost 20 hours if it was given correctly.
“We contacted the doctor and he said to just monitor the patient. I filled out an incident report, and we re – started the infusion at the correct dose. I believe I got confused because of all the different numbers on the IV bag, and I was also very busy that night.
“The result of the error was a critical potassium of 2.1. Fortunately, we had a potassium protocol to start potassium IV 50 mL/hr for six bags total and rechecked the leveI.
“I feel dumb and incompetent as a nurse. I feel like my life is ruined. I don’t know what to do. What if nursing just isn’t the profession for me after I’ve worked so hard for it. I’m so distraught.”
Here is what I would say to this nurse: No one ever promised you that you would never make a nursing error. You made an error and did all you possibly could to correct it. You reported the error, you contacted the doctor, and you worked with your charge nurse to make an immediate corrective action. You also analyzed the situation to determine why you made the error. You’ve learned a lesson; perhaps your experience can help keep others from making the same error. You’re a good nurse. Now, the most important thing you must do is to forgive yourself.
One of the vital lessons here is the concept of self-compassion—being warm and understanding toward yourself when you make a mistake, rather than punishing yourself with self-criticism. Self-compassion entails treating oneself with kindness, recognizing one’s shared humanity, and being mindful when considering negative aspects of oneself.
Several recent studies investigated the cognitive and emotional processes by which self-compassionate people deal with unpleasant life events. In the various studies, participants reported on negative events in their daily lives, responded to hypothetical scenarios, reacted to interpersonal feedback, videotaped performances in awkward situations, reflected on mistakes, and judged themselves for what they considered to be immoral behaviors. These studies yielded the following results:
• Self-compassion predicted emotional and cognitive reactions to negative events in everyday life.
• Self-compassion buffered people against negative self-feelings when imagining distressing social events.
• Self-compassion moderated negative emotions after receiving ambivalent feedback.
• Low-self-compassionate people undervalued their videotaped performances relative to observers.
• Self-compassion leads people to acknowledge their role in negative events without feeling overwhelmed with negative emotions.
• The more self-compassionate people are, the less acceptable they rated their own moral transgressions. Moreover, this study measured participants’ willingness to take responsibility for actual choices that participants believed were immoral. Self-compassion seemed to increase rather than decrease people’s willingness to take responsibility for misbehavior.
It’s worth noting that studies found that a sense of ethics and developing a moral compass are essential parts of self-compassion. Ethics is all about how we treat other people and, as a consequence, is closely related to morality—how we determine whether our behavior toward others is good or bad. The point these researchers make—and it’s a good one—is that you also are a human being—and thus, you also deserve to be treated with compassion.
Leah Curtin, RN, ScD(h), FAAN
Executive Editor, Professional Outreach
American Nurse Today
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Neff K. Self-Compassion: The Proven Power of Being Kind to Yourself. New York, NY: William Morrow Publishing; 2011.
Terrible medication error. Allnurses website. 2013.
Xue W, Zhansheng C , Kai-Tak P , Fei T , Shenghua J. Self-compassion decreases acceptance of own immoral behaviors. Personality and Individual Differences. 2017;106:329-33.