Saying "I'm sorry" should be okay.....
I have seen a recent resurgence in the news about medical apologies. According to a
recent article on MSNBC, Rhode Island is trying to join 27 other states that have passed laws forbidding an apology from a doctor to be used in a law suit against them.
This should be common sense. So often, events just happen. It’s not always the result of negligence or bad medicine, it’s life. Doctors are not gods; they are human beings. Not everything is in their control. A routine procedure could turn into a life threatening event that no one could predict. And if it were me, I would want to hear someone say, “I’m sorry.”
Maybe I feel this way because I work in the ER, the place where people go when complications or accidents threaten their lives. I see how the human body is still a mystery to doctors and nurses.
Take Mr. B. for example. He is a 54 year old male comes to the ER complaining of abdominal pain. He has a medical history of high cholesterol and hypertension. He takes Norvasc and Lipitor. He has no known drug allergies.
My assessment reveals that it is a diffuse pain, his abdomen is tender to palpation, and he has decreased bowel sounds. He had a fever yesterday with some nausea, no vomiting and a normal bowel movement last night. How many different diagnoses can come from this assessment? I can tell you, a lot. How do we find it? We begin a battery of tests such as X-ray, CT scan, blood work and probably a surgical consult. Meanwhile, we wait.
Eventually, he will be diagnosed with appendicitis, go to the operating room for a laparoscopic appendectomy. His recovery is expected to be swift and uneventful. But what if he has a heart attack on the operating table or after surgery? What if he has a stroke or an infection of the incision site that takes his life? Should somebody have known this was going to happen? And, because it did, should someone be held responsible?
This might sound cold, but, I believe that no one can be “blamed” for things that happen. But, health care is complicated. Mr. B. or his family would have had to sign a consent, stating that they understood the risks of surgery. But, still, that can be overridden in a civil court case. And if the doctors or nurses expressed compassion afterward, they can be taken into court and have their sentiments used against them. I think this is what is damaging so much of our health care today. We, as health care providers, are forced to be so preoccupied with protecting ourselves that we lose the ability to care.
I am a nurse because I want to care. I don’t believe I provide a service in terms of business. When bad things happen to people, I feel it. It affects me even when I am not at work. And I want to be able to share it with the family when in it occurs, but I can’t (or I’ve been taught that I shouldn’t), because it could come back to haunt me. So where does that leave us? It leaves me scared to show emotion and afraid to embrace the human frailty that surrounds me each day. It also projects a pompous image to those not well versed in the medical field. And, in so many cases, it leaves families feeling angry and helpless.
Can saying ‘I’m sorry’ soften the blow? Maybe not all the time, but I think it’s a good place to start. Who wouldn’t want their suffering validated? I mean, at its core, isn’t that what lawsuits are about? For some, it is only about the money; I know because I’ve been in that situation. But the majority of people just want to be acknowledged.
So, to Mr. B.’s family, I would want to say I am sorry that life has thrown you a curve ball. The road to recovery shall be a lot longer and harder than you expected, but I care enough to want to make it less painful. I can’t change what has happened and neither can the doctor, but as a team we can work together to get through this.
It’s sad to me that it takes a law to make this possible, but that’s the world we live it today. Hopefully we can change it with one small apology at a time and begin the real work of healing the problems with healthcare. It’s time we moved into a more emotional, respectful, and peaceful way of taking care of each othe