Background and purpose To explore the experience of committing medical error from the perspective of nurse practitioners (NPs). Overall, the purpose of the study is to discern NPs’ behaviors, perceptions, and coping mechanisms in response to having made a medical error. Methods Qualitative research based on two face‐to‐face audio‐recorded semistructured interviews with 10 NPs who had made medical errors in practice. The analysis was guided by concepts in phenomenology. Conclusions During iterative analyses, four overarching themes were identified: (a) The paradox of error victimization, (b) primacy of responsibility and mindfulness, (c) yearning for forgiveness and a supportive other, and (d) coping with a new reality is context dependent. The narratives strongly suggest that NPs who err experience “second victim” phenomena. Implications for practice Reminiscing about the experience of living through an error, NPs shared meaningful insights into their need for a safe environment in which they could candidly share feelings, reflect on the experience, and ascertain the etiology of the mistake. Debriefing in a formal manner might prevent the development of permanent psychological injuries. Hence, inherent to the care of “second victims” is the notion of co‐workers’ fairness, compassion, and recognition of appropriate caring responses that contribute to effective coping and healing.

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Hyperthyroidism in the elderly population is often associated with atypical, blunted, or nonspecific signs and symptoms, also known as apathetic hyperthyroidism (AH). The absence of the classical hyperkinetic clinical presentation can be confused with the normal aging process, or other diseases, and often leads to misdiagnosis, delayed treatment, and negative outcomes for elderly patients. We provide a case study of an elderly patient to illustrate the atypical presentation of AH. The vignette also highlights a diagnostic and treatment approach based on geriatric medicine fundamentals and evidence-based research. We then review the multiple factors and pathogenetic mechanisms contributing to endocrine disruptors and the paucity of hyperadrenergic signs and symptoms in the elderly with hyperthyroidism. Additionally, the article contrasts the symptomatology and diagnostic profile between primary hyperthyroidism and AH. Finally, we provide an evidence-based, patient-centered approach to manage AH in the elderly population. We recommend that nurse practitioners cultivate illness script inclusive of atypical presentations to guide their clinical decision making. Psychomotor retardation with or without cardiovascular symptoms warrant a high degree of suspicion and the initiation of laboratory studies, including thyroid functions to confirm or rule out hyperthyroidism.