Saying the Forbidden Words that Heal: I’m Sorry

I’ve been struck the last couple of days in the myriad of opportunities to say I’m sorry. There seems to be an unspoken rule, fed by fear, that this phrase is forbidden in healthcare; it implies admitting fault to the quality of the clinical care and opening oneself up to a lawsuit. It seems to be the same as saying, “Sue me.”

But it’s not the same. Over and over I see opportunities to listen to the many ways healthcare has impacted someone’s life, and to simply offer an apology for the parts of their experience that could have been improved with more information, more compassion, or simply less noise.

Healthcare workers are put in situations day in and day out that require an inhuman ability to make the right decisions and follow protocol, perfectly.  While we automate  and mistake proof (poka-yoke) as much as we possibly can as in the case with bar code medication administration, the fact remains: where there are humans giving care there will be mistakes in care.

The crucial moment comes after the mistake is made. Are we able to listen, apologize, and do what we can to help heal the hurt we’ve caused or do we turn a blind eye and continue on? How we answer that question changes everything.

An apology heals. Honesty heals. Transparency Heals.

Apologizing does not necessarily mean agreeing with or admitting one side is right or wrong. It’s an acknowledgement of their suffering and a demonstration of our empathy. Lisa Goodman Hefland argues the future of healthcare rests on the ability to humanize our interactions in this way:

Many will argue that the future of medicine hinges on innovative technology and propelling scientific research forward. While I agree these are critical elements, I maintain that in our new digital world, we can’t discredit the role that humanity and empathy play in medicine. It’s an arduous task to balance the benefits of innovation with the heart of medicine. To me, the future of medicine rests on the ability of medical professionals to see patients as people, not data. Only then, can we begin to change the culture of medicine and cultivate an environment where medical error is acknowledged and examined, protocols are changed, and apologies are made. 

From: Medical mistakes happen. It’s what doesn’t follow that is unforgivable.

The more we learn to say these two simple words and improve the culture, systems and processes that contributed to the situation the more we will be impacting the well being of the lives we serve.

Have you had an opportunity to say I’m sorry lately? Tell me about it below!

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6 comments

  1. Saying I am sorry might be hard when you first say it to a patient or family, however as Danae states, it is not meant to admit anything was done incorrectly, it is simply stated to say I am so sorry for your experience. After you practice saying this to patients it becomes easier and as patients and family’s anxiety and fear and even anger decrease when you say it, you realize how powerful those three words really are. They help validate the person’s perception that we are not meeting their needs at this point in time, and saying I am sorry now opens up the window where we can right the course of care, pay more attention to the patient and family’s concerns and make it a positive and memorable interaction and experience as opposed to one in which we ignore the patient’s concerns and fears and worries. Practice saying it and you will see a stronger connection with your patients as you invite them to tell you what really matters to them instead of continuing to defend what we are doing is always the right way. Doing things with our patients is the way we need to go in healthcare, not doing things to them or even for them, but with them. Listening to their experience along the way will help us improve both the quality and the service we provide to our patients and their families. This has been shown to promote increased adherence to the plan of care, when we connect with our patients which also leads to better outcomes for the patient. So much can come from saying I am sorry at just the right time and situation. Thank you Danae for your very interesting and thought provoking blogs!

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    1. I like how you mention that it may be difficult at first but after doing it, you see the way it opens doors for deeper conversations about how we can help meet their needs. I’ve definitely experienced this. Saying I’m sorry is a pivotal moment in the conversation, and most of the time sets the dialogue in a new, productive direction.

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  2. Great job Danae! There is both research and evidence that shows when a healthcare organization and its representatives are transparent and empathetic (I am sorry), there is a reduction in what could/would have otherwise turned into litigation. However, regardless of all of that, it’s simply the right/humane thing to do.

    Why is it that our culture expects and in many cases demand an apology if our meal is not cooked correctly at a restaurant or an attendant is not of the highest service delivery caliber in a department store, yet we continue to tolerate in humane behavior when people are at the most vulnerable times/circumstances of their lives while being a patient at the mercy of the healthcare delivery system and its people? You are right on…we as healthcare professionals must change this! And I believe WE can do this!

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    1. Thank you for commenting Kris! You are right: in the most vulnerable times, we need to not be hesitant to utter these very important words! I’ve always been so inspired by your passion and ability to influence others for positive change in healthcare. You are absolutely right- We CAN do this!!

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