The Importance of Apologies

Marie Prothero received the college’s 2016 Alumni Achievement Award in recognition for her contribution to the nursing profession. This article contains excerpts from her BYU Homecoming address, delivered October 13, 2016.

“I believe that for us to move healthcare forward into achieving quality healthcare and outcomes, [we must] have transparency,” says Marie Mellor Prothero (MS ’96), MSN, RN, FACHE. A nurse administrator, Prothero is the executive director of quality for St. Mark’s Hospital in Salt Lake City. She oversees quality assurance for her organization that includes electronic reporting, patient concerns, and physician compliance. She also strives to improve process flow and safety efforts.

Prothero is currently working on a PhD in nursing from the University of Utah; her dissertation is focused on transparency in healthcare and the role of an apology following a medical error.

The attributes of an apology include expressing regret and sorrow, admitting fault with a statement that an error occurred, listening with dignity and respect, correcting the mistake and ensuring it will not happen again, and offering restitution to the victim.

Her studies highlight several antecedents, such as why we apologize and the corollaries of not apologizing when there is a medical mistake or accident.

“We must realize [that the] consequences of not apologizing affects our emotional, spiritual, and physical well-being,” says Prothero. “And if left unresolved, [mistakes] can create feelings of bitterness and even increase litigation and settlement costs.”

To give an effective apology, one must express regret and sorrow; you cannot fully apologize without remorse. “A conversation casually informing a patient of the error is inadequate,” says Prothero, “and so is a statement that seems forced and insults others’ intelligence.” Appropriately apologizing takes the right setting and practice.

Prothero’s research serves as a starting point for additional inquiry to explore the nature and types of apologies. It will help other nurse leaders identify what comes after the apology and if the patient-provider relationship can be repaired.

“There must be ongoing communication as additional details are learned—with the patient and family members, as well as with unit staff and hospital administrators,” she says. “Once we identify system changes, we need to involve others in the process to ensure needs are met and proper training occurs.”

Further, Prothero’s studies clarify the role of nursing in disclosure, apology, and the creation of a culture of safety in which everyone feels valued and able to speak up. “We must continue the important work of quality assurance, process improvement, and system improvement,” she says. “Never forget that every patient matters.”

She also emphasizes that nurses have the opportunity to be leaders with a broad impact in their organization.

“Leadership is interdisciplinary and [is] a team approach,” she says. “You must know your strengths and weaknesses and understand what you bring to the team. Then surround yourself with people who are different from you and learn from each other for success.”

Prothero has been a leader her whole career. Before St. Mark’s, she was the CEO of Utah Valley Specialty Hospital in Provo for seven years, a CEO of Ernest Health for four years, and an operations officer with Intermountain Healthcare for 22 years.

“Never stop learning and developing your nursing and leadership skills,” she concludes. “Success comes from ensuring the success of your peers. Take time to remove roadblocks, recognize achievement, and encourage others. By being a positive influence, you can see the best in your team.”

 

One thought on “The Importance of Apologies

  1. Being a victim of your own alumni, I disagree apologies will never repair the pain and suffering a doctor can intentionally cause disregarding the patients life completely. The doctor is not to be seen by other patients.

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