Although the physician's Hippocratic Oath does not actually contain these words, it is definitely implied that all members of the health care team should always strive to do no harm. What does this mean? Certainly, as human beings, no one is perfect. However, by virtue of the fact that nurses hold lives in their hands, they are expected to do all that they can to not harm anyone. Mistakes can happen and inevitably they will, but there are rules in place to help to alleviate the possibility of mistakes. It is the responsibility of all nurses and all members of the health care team, to follow those rules to ensure the safety of all.

One problem is that some nurses get very lax in performing all the double checks that help to prevent errors. You may know a patient personally or have spent significant time with her and feel a little too confident that you don't need to check the name band with each medication administration. The first time your confidence betrays you, however, will be a devastating mistake. It may not in any way be harmful to the patient, but your own self-confidence will take a dive.

Every day your commitment to make a difference in someone's life should include doing all that you can to prevent mistakes. In addition, you need to have a good understanding not only of your scope of practice, but that of your coworkers as well. You want to have a clear idea of what others are capable of as well as what they are allowed to do so that you don't expect a level of understanding that is not there.

Harm can be done, for example, by expecting an aide to understand the correlation of the symptoms she is reporting to the untoward events of the day for that patient. Nurse's aides and LPNs do not assess. Therefore, it is the R.N.'s responsibility to obtain reports from the aides and LPNs as often as possible and to direct them in what other symptoms she expects to be reported immediately.

No matter what level of nursing you are functioning at, it is always in your own, as well as the patient's, best interest to understand each person's scope of practice. If you are the aide or the LVN, you aren't responsible for, nor expected to assess and analyze the data. However, it can be in everyone's best interest to have an understanding of what other symptoms might be important to report and why. This can be especially important and helpful in the event of short staffing. Concise communication is vital to quality patient care. If you are ever in doubt, it is always best to ask for assistance or another opinion. To err on the side of safety is always best.

It is vital to remember if you are an aide or LVN, that even though you can utilize these situations to improve your knowledge base, that, first, nurses never diagnose and, second, you must remember your scope of practice and always work within these parameters.

If your significant other kept you up all night sitting in the ER because of an illness or injury, you aren't going to function at the optimum level in your practice of nursing. You cannot safely perform your duties as a nurse if you are impaired. If you have a fever and severe head cold, your judgment will be impaired (not to mention your illness is contagious). These are times when you need to call in sick.

On the other hand, you have a responsibility to be at work when you are assigned. Don't choose the night before to party all night. Don't decide to watch the entire twenty-four-hour marathon of your favorite old TV show. Be responsible. Plan your life around your job. Your first responsibility as a nurse is to your patients — to be the best nurse you can be. You cannot do this if you are not prepared.