to the patient honestly is crucial. If something has gone awry during
surgery, the provider should first go into recovery, or another private
area, and have a discussion with the family and/or patient. Take the
patient by the hand — don't be afraid to do this — and make them as
comfortable as possible. Sit down and give them adequate time to dis-
cuss what happened.
This process doesn't mean you should admit fault, but it does mean
that you should try to truthfully explain the problem. These conversa-
tions should attempt to answer the big questions that the family and
patients will have. Start by explaining the injury, the risk factors and,
finally, the safety precautions you took.
For example, if it's a nerve injury after a peripheral nerve block, you
might say something like: "It seems like you've suffered a nerve
injury during the block. This is a rare, but known, risk in this pro-
cedure, and we took several steps to try and prevent it, including the
use of ultrasound." Afterwards, let them ask questions. If you don't
know an answer to their question, say that, but add that you'll look
into it further and get back to them promptly — and then do so.
A p ol og i ze — th e r i g h t w a y
Once the patient/family understands the problem, the provider should
then apologize. This can be tricky — you don't want to admit any
fault, since in some cases that can legally be used against you, but you
do want to be empathetic to the patient who may have just been
injured. After you explain what happened, simply tell the patient that
you're sorry that they have to go through this. Express empathy, and
let them know you'll revisit your policies to look for anything that
could help prevent this from occurring in the future.
This last step may seem contentious to some, but it can be an effec-
tive way to help the patient while avoiding a lengthy and costly law-
Medical Malpractice
MM
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