Top Ten Things To Never Do In Nursing

You have probably heard of the infamous “never events”—those serious, preventable incidents the government refuses to reimburse hospitals for. These include things like development of pressure ulcers, wrong site surgery, and foreign objects retained after surgery. They’re called “never events” for a reason: they should never happen.

Inspired by that, I created a Nursing NEVER-DO List—a collection of things that should never happen in your practice if you want to protect your license, your patients, and your peace of mind.

NEVER pre-chart in the medical record.

You simply can’t predict the future. I’ve seen too many nurses brought before the Board for documenting assessments or actions before they occurred, only to have something unexpected happen. Never pre-chart. Always chart in real-time or as close to it as possible.

NEVER prearrange or “prep” meds by taking them out of packaging before you’re ready to administer.

It might seem efficient, but if there’s a delay—or the patient refuses, crashes, or gets transferred—you’ve created a medication safety issue and a potential liability.

NEVER remove medications from the Pyxis early and carry them around.

Even if you are trying to stay ahead of the game, this raises red flags in audits and can lead to accusations of diversion if there is any delay in documentation or delivery.

NEVER carry meds in your pocket “just in case.”

If the patient is asleep or refuses them, always return the meds per protocol. Holding on to meds—even briefly—opens you up to risk and suspicion.

NEVER sign off on a narcotics waste you didn’t personally witness.

It may feel like a small favor to a colleague, but it’s a serious breach that can land you in hot water with management, the Board, or law enforcement.

NEVER document anything you didn’t actually do.

This might seem obvious, but documentation errors—intentional or not—can be interpreted as fraud. If someone asks you to fill in the holes in the chart, do not do it.

NEVER leave out any prior jobs on a job application.

Facilities check. Omissions may appear like you’re hiding something, which can affect your credibility—or your job offer. It is also considered fraud and misrepresentation in getting a job.

NEVER forget to document co-care providers.

If someone else inserts the IV, calls the doctor, or performs any task—note it. Good documentation is clear, collaborative, and protects everyone involved. If you want to document something someone else did, chart what they did and who did it.

NEVER act outside your scope of practice—or beyond your facility’s policies.

Just because one hospital allows a nurse to remove a central line doesn’t mean another does. Know what your state board allows and what your facility policies support. When in doubt—ask and document the answer.

NEVER forget to renew your license.

It sounds like a no-brainer, but life gets busy. Practicing with an expired license is not only unprofessional—it can be criminal.

And a few bonus “NEVERs” worth remembering:

NEVER ignore your gut. If something feels wrong, slow down and double-check.

NEVER minimize a patient’s concerns. Even if it seems minor, document it and report it appropriately.

NEVER assume someone else will handle it. Whether it’s a follow-up, a critical lab, or a call to the provider—if you notice it, own it.

This list isn’t exhaustive, but it’s a solid place to start when thinking about the daily choices that protect your license, your livelihood, and most importantly—your patients. In a healthcare environment that often pushes nurses to the edge, remembering what to never do can be just as powerful as remembering what to always do.