How to handle mistakes as a nurse? A comprehensive guide for healthcare professionals

September 29, 2025 •

4 min read

Medical errors can contribute to thousands of patient deaths annually, making a nurse's response to mistakes critically important. Knowing how to handle mistakes as a nurse is not just about professional accountability, but about safeguarding patient well-being and fostering a culture of safety.

Quick Summary

Taking responsibility for a nursing error requires a systematic approach involving immediate reporting to a supervisor, transparent communication with the patient, thorough documentation, and reflective practice to prevent future issues while protecting your mental health.

Key Points

Acknowledge and Report: The immediate reporting of a mistake to a supervisor is critical for patient safety and ethical practice.
Prioritize Patient Safety: The first action must always be to assess the patient and take steps to mitigate any potential harm caused by the error.
Document Accurately: All actions must be documented truthfully and objectively in the patient's chart and a separate incident report for quality improvement.
Reflect to Learn: Engage in reflective practice to understand the root causes of the mistake, and resist the urge to ruminate on guilt and shame.
Seek Support: Talk to trusted colleagues, mentors, or counselors to process the emotional impact of the mistake and gain a wider perspective.
Promote Systemic Change: Use the incident as an opportunity to improve processes and prevent similar errors, contributing to a Just Culture of safety.
Pursue Continuous Growth: Commit to ongoing education and skill-building to enhance your competence and reduce the likelihood of future mistakes.

Responding Immediately: The First 5 Steps

When you realize a mistake has occurred, your immediate and honest response is the most critical factor. The following steps must be taken promptly to mitigate harm and ensure patient safety.

1. Acknowledge and Assess

First, acknowledge the mistake calmly and immediately. Your top priority is the patient's well-being. Assess the patient's condition for any adverse effects caused by the error. This may involve taking new vitals, performing a specific assessment, or initiating an intervention as per protocol.

2. Inform Your Supervisor

Report the error to your supervisor or charge nurse immediately. Do not attempt to hide or downplay the mistake, as this is a serious ethical violation and can lead to severe consequences for the patient and your license. Your supervisor will help guide the necessary steps to rectify the situation and ensure patient safety protocols are followed.

3. Disclose to the Patient

Transparency is a cornerstone of ethical nursing practice. If appropriate and in accordance with hospital policy, disclose the error to the patient and their family. The American Medical Association's Journal of Ethics suggests stating the facts clearly, without blame, expressing sincere regret, and explaining the steps being taken to correct the error. Having a supervisor or physician present during this conversation can be helpful.

4. Document Thoroughly and Objectively

Proper documentation is essential. Your charting should include the following:

What happened and when.
The patient's condition before and after the mistake.
All actions taken to mitigate the error.
Who was notified (e.g., supervisor, physician).
Any further monitoring required.

Crucially, never speculate on the cause or blame others in the patient's chart. A separate incident report, which is not part of the patient's permanent medical record, should be completed to document the event for internal quality improvement purposes.

5. Follow Up and Monitor

After the initial steps, continue to monitor the patient for any delayed complications. Following up shows your commitment to their care and reinforces trust.

Coping with the Emotional Toll of a Mistake

Making a mistake can be emotionally devastating, leading to feelings of guilt, shame, and anxiety. It is important to address these feelings constructively rather than allowing them to define your career.

Reflect, don't ruminate: Reflection is a healthy process of analyzing the situation to learn from it. Ruminating, however, is obsessively dwelling on the mistake, which perpetuates negative thoughts and can lead to burnout. Ask yourself what you can learn from this and what steps you can take to move forward.
Seek support: Talk to a trusted colleague, a mentor, or a therapist. Sharing your experience can help you process your emotions and remind you that you are not alone. Many healthcare facilities offer employee assistance programs (EAPs) that provide confidential counseling.
Forgive yourself: Understand that you are human and mistakes, while serious, are part of the learning process. Self-forgiveness is a process, not a single event. It starts with owning responsibility and committing to improvement.

Fostering a Culture of Safety Through System-Based Learning

Individual errors often point to systemic flaws. By participating in a "Just Culture," healthcare providers move past a simple blame-and-punish model to one that examines the root causes of errors. A Just Culture recognizes that competent professionals make mistakes and focuses on redesigning systems to prevent future errors.

Root Cause Analysis (RCA)

After a significant error, a Root Cause Analysis may be performed. This involves a team investigating the event to identify all contributing factors, such as communication failures, fatigue, equipment issues, or inadequate training. Your honest participation in this process is crucial for identifying weaknesses and implementing effective solutions.

Use Incident Reporting for Improvement

Incident reporting systems are designed to gather data that helps organizations improve safety. Reporting even near-misses is valuable. For a reporting system to be effective, it must be easy to use and provide feedback to the reporter on what was done with the information.

Comparison of Unproductive vs. Constructive Responses


Aspect	Unproductive Response	Constructive Response
Reporting	Hiding the mistake; fearing discipline.	Acknowledging and reporting immediately to your supervisor.
Emotional State	Ruminating on guilt and self-blame.	Reflecting, seeking support, and focusing on learning.
Patient Interaction	Avoiding the patient; being defensive.	Being transparent and empathetic; prioritizing patient care.
Professional Growth	Dwelling on the past; losing confidence.	Using the mistake as a catalyst for future improvement.
Teamwork	Isolating oneself; gossip; blame.	Seeking peer support; participating in root cause analysis.

Actions for Long-Term Professional Improvement

Use the experience of a mistake as a powerful catalyst for growth. Take proactive steps to enhance your practice and knowledge.

Continuous Education: Attend workshops, simulations, and continuing education programs to stay current with best practices and address any knowledge gaps identified by the error.
Mentorship: Seek guidance from a trusted, experienced nurse. A mentor can offer valuable perspective, share their own experiences, and help you navigate the path forward.
Process Improvement: Become an advocate for change. Share your insights during team meetings and contribute to developing strategies that address the systemic issues that led to the error.

Remember that while a mistake is a serious event, your response and commitment to learning are what define your professionalism. The path to becoming an expert nurse is built not only on flawless performance but on the courage to face and learn from imperfections. For more ethical guidance in healthcare, refer to the American Medical Association Journal of Ethics.

Conclusion

Making a mistake as a nurse is a deeply human experience, but the professional responsibility lies in how you respond. By prioritizing patient safety, acting with honesty and integrity, and engaging in transparent communication, you uphold the ethical standards of your profession. Seeking support, reflecting constructively, and participating in system-wide improvements will not only help you move past the event but will also contribute to a safer and more effective healthcare environment for everyone.

Frequently Asked Questions

The moment you realize an error, assess the patient's immediate safety. Then, notify your supervisor or charge nurse immediately to initiate the appropriate protocol for correcting the mistake and ensuring the patient receives optimal care.

No, hiding a mistake is a serious breach of professional ethics and can lead to severe harm to the patient and legal repercussions for the nurse. Prompt and honest reporting is always the correct course of action.

Coping involves seeking support from colleagues, a mentor, or a therapist. It's important to differentiate between productive reflection and destructive rumination. Use the experience as a learning opportunity and practice self-compassion.

Document all facts accurately and objectively in the patient's medical record, including the actions taken to address the error. A separate, non-punitive incident report should be filled out for the institution's quality improvement efforts. Do not include speculation or blame.

A Just Culture is a healthcare philosophy that moves beyond blaming individuals for errors. Instead, it focuses on identifying and fixing the systemic issues that allowed the mistake to occur, recognizing that even competent professionals make errors.

To learn from an error, participate in a root cause analysis, engage in targeted continuing education to address knowledge gaps, and share the experience with trusted colleagues to educate others and prevent similar incidents.

Disclosing the error to the patient is an ethical responsibility, and it should be done transparently, with empathy, and in accordance with your institution's policy. A supervisor or physician should be involved to ensure proper communication.

Your priority is patient safety. If you see a colleague make an error, gently and privately bring it to their attention so they can take immediate corrective action. If they fail to act, you must escalate the issue to a supervisor to protect the patient.