Always Having to Say You’re Sorry: an ethical response to making mistakes in professional practice

Abstract

Efforts to decrease errors in health care are directed at prevention rather than at managing a situation when a mistake has occurred. Consequently, nurses and other health care providers may not know how to respond properly and may lack sufficient support to make a healthy recovery from the mental anguish and emotional suffering that often accompany making mistakes. This article explores the conceptualization of mistakes and the ethical response to making a mistake. There are three parts to an ethical response to error: disclosure, apology and amends. Honesty and humility are discussed as important virtues that facilitate coping and personal growth for the health care provider who is involved in mistakes. In conclusion, a healthy view of nursing practice and mistake making is one that prevents error but, when prevention is not possible, accepts fallibility as part of the human condition and achieves the best possible outcome for all.

Pflegefehler und die Folgen. Ergebnisse einer Befragung von Pflegendenin stationären Versorgungseinrichtungen

“…In einer der wenigen Studien zum Thema berichtet Arndt (1994) (Crigger, 2004). Sie schä-men sich, klagen sich selbst an und stellen sich auch als Person infrage (Crigger & Meek, 2007).…”

Dealing with Errors on the Job

“…This view is apparent in nursing, as nurses are not supposed to make errors (Crigger, 2004). Not only do nurses place high expectations on themselves to be faultless practitioners but assume a major responsibility for patient safety.…”

“…However, there is much less emphasis how individual nurses resolve their personal conflicts associated with their mistakes so they can continue to view themselves as proficient and caring professionals. When errors occur, Crigger (2004) recommends a process of disclosure, apology, and if possible, making amends. Following this approach is thought to be most beneficial in terms of protecting the patient, resolving any longterm emotional issues for the nurse, and lessening chances of litigation.…”

Exploring patient strategies in response to untoward healthcare encounters

“…26 If Ingrid acknowledged Anna's suffering, a feeling of regret might arise, which might lead to altered future behaviour and personal growth. 27 This opportunity for learning may also come into being if Anna chose to write a letter to the head of the clinic, who in his or her turn would confront Ingrid. However, the impact of Anna's suffering on Ingrid's moral feelings is probably influenced by physical proximity.…”

“…There is a risk that Anna will feel even more devastated if her voice is ignored or if staff respond with domination techniques. 37 However, if Ingrid voices her regret, in return this can have a healing effect on Ingrid, 27 as well as on Anna, as patients can feel relief when their feelings are confirmed. 36 Regardless of whether the provider responds in a satisfactory way, any form of voicing probably serves a venting function for patients, i.e., it is a way to release distress.…”