To do no harm.
A thunder clap awoke the entire village at 1am. My eyes burst open like the lightning that filled our room, and in the immediate aftermath I heard my littlest sister whimpering across the hallway. Misha and I both called out to have her join us, but Sanna’s fingers were tightly placed within both ears, which is how we found her when we went to escort her to our bed. The three of us tucked beneath our summer quilt, I stayed wide awake for 1 second more, and then a deep-stormy sleep overcame me and all was oblivion.
The morning post-storm is peaceful, the air tastes thick of cool mint julep. Damp earth and foggy sunrise, the house stays quiet as I sit at the table, pondering my errors.
It reminds me of yesterday’s sunrise that shone through wispy clouds and radiated over the hills while my car zoomed over the ups and downs of the landscape. Shifting down a gear, I let myself slow and absorb it all. The prayer is still fresh on my lips,
Please help me to do no harm.
This is my plea every single time I head into work. Because I’m new, this hospital is new, this whole thing is new, and there’s a lot of risk in new.
New is exciting, it’s distracting, it’s overstimulating. The buzz in new relationships can lead to negligent decisions, rash actions, and regretted words. The same kind of buzz, the same kind of newness as a new nurse, new teacher, new employee can be a breeding ground for mistakes. With a scant amount of experiences to act as a sounding board for necessary immediate actions, it is difficult to understand consequences, or evaluate outcomes.
Newness is great, but boy is it risky.
I won’t ever forget the day I was talking to my patient about how mistakes are great to learn from, but the best kind are those that do no harm to other people. He is telling me some story and I am about to give him tylenol.
Nodding along in agreement, I pop the tablets out and place them in the little plastic cup. I hand them to him. He empties the cup onto his tongue and, with a gulp of water, swallows.
I turn around to the computer.
My eyes widen.
I had totally forgotten to scan the medication.
I had simply given it to him.
In retrospect, I truly have no idea how I ended up doing that, seeing as proper med administration has been drilled into my head so much that there’s no longer available space for more screws to be drilled in. Which makes the point of this all: entirely new responsibilities and lots of things swirling around in the brain will make you do stupid things.
I mentally kicked myself and then within a split second regained composure. He’s still telling me his story, and I realize: you’re okay, he’s okay, and it’s all going to be okay. It was only one medication, it was the right medication, the right dosage, and the right patient. Where I went wrong was forgetting the whole documentation and computer-checking part (which could still be done, simply not in the right order).
Which, I should add, is definitely an important part.
But the irony of it was not lost on me. I had just told him that a mistake where no harm is done is the best kind. And then I proceeded to do that exact thing.
There’s also the day I forgot to clock in, the day I forgot to fill out a specific paper for a discharge, the day I ran an IV antibiotic at the wrong rate but caught it in time, that time I looked totally novice while flushing a midline because I wasn’t sure what I was doing, and that time, (in clinical), that I put a patient on her bedpan the wrong way.
They say go with what your gut is telling you. So that is why I always make sure to eat ice cream since that’s what my gut is telling me most of the time. But besides that, I truly have heard my gut talk to me during all those times that I made those mistakes. Yet I did not heed its whispers.
The morning post-storm is peaceful, the air tastes thick of cool mint julep. Damp earth and foggy sunrise, the house stays quiet as I sit at the table, pondering my errors.
It reminds me of yesterday’s sunrise that shone through wispy clouds and radiated over the hills while my car zoomed over the ups and downs of the landscape. Shifting down a gear, I let myself slow and absorb it all. The prayer is still fresh on my lips,
Please help me to do no harm.
This is my plea every single time I head into work. Because I’m new, this hospital is new, this whole thing is new, and there’s a lot of risk in new.
New is exciting, it’s distracting, it’s overstimulating. The buzz in new relationships can lead to negligent decisions, rash actions, and regretted words. The same kind of buzz, the same kind of newness as a new nurse, new teacher, new employee can be a breeding ground for mistakes. With a scant amount of experiences to act as a sounding board for necessary immediate actions, it is difficult to understand consequences, or evaluate outcomes.
Newness is great, but boy is it risky.
I won’t ever forget the day I was talking to my patient about how mistakes are great to learn from, but the best kind are those that do no harm to other people. He is telling me some story and I am about to give him tylenol.
Nodding along in agreement, I pop the tablets out and place them in the little plastic cup. I hand them to him. He empties the cup onto his tongue and, with a gulp of water, swallows.
I turn around to the computer.
My eyes widen.
I had totally forgotten to scan the medication.
I had simply given it to him.
In retrospect, I truly have no idea how I ended up doing that, seeing as proper med administration has been drilled into my head so much that there’s no longer available space for more screws to be drilled in. Which makes the point of this all: entirely new responsibilities and lots of things swirling around in the brain will make you do stupid things.
I mentally kicked myself and then within a split second regained composure. He’s still telling me his story, and I realize: you’re okay, he’s okay, and it’s all going to be okay. It was only one medication, it was the right medication, the right dosage, and the right patient. Where I went wrong was forgetting the whole documentation and computer-checking part (which could still be done, simply not in the right order).
Which, I should add, is definitely an important part.
But the irony of it was not lost on me. I had just told him that a mistake where no harm is done is the best kind. And then I proceeded to do that exact thing.
There’s also the day I forgot to clock in, the day I forgot to fill out a specific paper for a discharge, the day I ran an IV antibiotic at the wrong rate but caught it in time, that time I looked totally novice while flushing a midline because I wasn’t sure what I was doing, and that time, (in clinical), that I put a patient on her bedpan the wrong way.
They say go with what your gut is telling you. So that is why I always make sure to eat ice cream since that’s what my gut is telling me most of the time. But besides that, I truly have heard my gut talk to me during all those times that I made those mistakes. Yet I did not heed its whispers.
There are other times though that I did pay attention to my rumbly hungry gut and the result was always good: like the time I didn’t give my patient their coumadin even though it was almost due because I just felt like I should wait--and five minutes later the doctor tells me he wants to d/c (discontinue) the med, so “do NOT give it”.
Or the time I sensed deep down that something was up with my patient and was able to catalyze the process of getting him the help he needed.
All the same, whether I come home from my day feeling that I did well, did so-so, or have a crazy-lot to learn (that’s everyday, by the way), the next day always finds me driving through those hills with that same prayer filling the cavities of my four-chambered heart:
Help me to do no harm.
All the same, whether I come home from my day feeling that I did well, did so-so, or have a crazy-lot to learn (that’s everyday, by the way), the next day always finds me driving through those hills with that same prayer filling the cavities of my four-chambered heart:
Help me to do no harm.
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