Telling the Patient or Carer

As we have already covered, before telling the patient, you must do all you can to make sure that they are not in any life-threatening danger. Once this is deemed that they are no longer in danger, you should tell the patient what has happened as soon as reasonably possible. However, before you have a conversation with them, there are a few things you should be sure about.

First of all, think about the setting in which the conversation will be happening in, preferably, they should be in a place that makes them feel comfortable. For example, do not tell the patient in a busy corridor that they have never been to, where it is very likely that other people will overhear what is being said. Another thing to consider is the support that the patient may need after or even during the conversation. Do your best to try and have someone close to them available for support, this could include a family member, a close friend or anyone else close to them. Also, think about what you're going to say to them, make sure that you share as much of the truth as possible and avoid things like over-embellishing the story with unnecessary details and making excuses for the mistake.

On the other hand, think also about what the patient would want to hear. Most probably they would want to know all of the facts, what mistakes occurred and why, and what if any, impacts the incident has had on their health. So once you have started the conversation, act as empathetically as possible. Of course, you should be acting in this way throughout the patient's care no matter what, however, in situations like these, acting empathetically is a necessity. Doing this will make them feel more comfortable and more likely to respond positively to any potential necessary changes and care offered to them.

Making an apology to the patient in a sincere way, lets them know whatever has happened was an accident. Should you apologise, it does not mean that you are admitting legal liability for the mistake made, but can actually help you, should something like fitness to practice be made against you. Rather than admitting blame, it would be viewed as having done the right thing. Having done all you can to make the patient feel better, as well as showing an insight into the situation. When making your apology, there are three main things you need to include. The first one is to tell them what has happened in as much details as they want to hear. This can also include what has happened directly after the incident and what care was immediately given if any.

Next, you should talk about what this will change in the terms of the patient's care as a consequence of the mistake. The final part is to include what will change in everyone's care in order to prevent the same mistake from happening again and to prevent any more possible harm from coming to others. This could be a simple, "we are doing everything we can to change X, Y, Z, so this does not happen again", as long as it is both true and sincere. During the conversation with the patient, you should not be expected to take any personal responsibility for things that were either out of your direct control or for someone else's mistakes. However, sometimes extra apologies from people higher up the working chain, such as the team lead or even management will make the patient aware that the mistake has been taken to its more senior people and it is being taken seriously.

The patient also has the right not to hear these details about the incident, if they don't want to. They should be given the option to opt-out of hearing about anything they do not want to and should they choose not to hear these details, then these wishes must be respected. Should this happen, be sure to record this, and it may even be a good idea to have another witness to see that these are in fact their wishes. Each organisation may have slightly different procedures and policies in place, so be sure to ask a senior member of staff what to do in your organization. The only time which a patient may need to know more details about their situation than they want to is if they need to be able to give informed consent about the suggested treatment plan or possible investigation.

Also, should the patient choose not to hear certain details at one time, they will always have the right to ask a later time about what these details were. Again, these must be respected as the patient's wishes. When you are closing the conversation, be sure to ask the patient if they have any further questions and answer as honestly as possible. Make sure that you clear up any confusion that the patient may have about the events of the incident or any consequences that have resulted from it. Be sure to ask them if there is anyone you can tell for them on what they would like to happen now. Remember, you should demonstrate compassion and sincerity throughout this conversation.