Table 2

Phase 2 qualitative interviews: illustrative quotes

Empathy for HCWsThe medical field is extremely complicated with all the medications and all the diagnoses, and bodies are extremely complicated units. So, to think that errors are not going to occur…that’s not reality. (PP#12)
And too many people put the doctor up on a pedestal and let the doctor direct it. And frankly, if I were a doctor, I feel that would be a lot of pressure as a human being to have on me. (PP#12)
So it just gave me these opportunities to be empathic towards her and understand how she must have felt and how horrifying, embarrassing and shameful this must have been for her as well. (PP#11)
Barriers to communication and healingWe repeatedly asked to meet with the anaesthesiologist, but he refused, and we knew, without even confirming it, we knew he had probably spoken to his lawyers…we knew what they were doing, they were protecting themselves. (PP#3)
As long as they didn’t say the words, they could brush it under the rug and blame it on something else or, actually it wasn’t even blame, it was just ignore it. (PP#5)
Unless you have that MD PhD at the end of your name, you’re just a parent, you don’t know anything, and, and that’s a struggle, umm, because who doesn’t know their kid the best. (PP#10)
Communication needsSo having staff who were meeting with us that understood the impact of harm on patients and families certainly would have helped…as families, we need to see the people that were involved, not the, you know, the person up on high who had nothing, were totally removed from the situation. (PP#5)
Even if you’re not able to do anything, just show the support to that person by acknowledging that there is a mistake. (PP#2)
There’s nothing wrong with that, to show that you’re vulnerable as well, ‘I’m sorry that you are having this bad experience, I feel badly about it as well.’ (PP#2)
I think it was the nurse leader who actually said “nobody wanted this to happen…it was a nice soft landing for us. (PP#11)
What patient’s need to healSomething is going to improve so that someone else doesn’t have to go through the same experience and then they would be able to move on. (PP#2)
Although individual people make mistakes, the system allows them to make mistakes, and so I’m all about let’s try to fix this, yeah, it is really shitty it happened to us but let’s try to prevent another family to go through that and they had no interest in doing that, so that was really disappointing. (PP#13)
I think there should be a patient advocate that has to be called right away…there should always be a team that deals with any kind of adverse, err, you know, error, or outcome, or even a bad experience in general that didn’t, that isn’t anyone’s fault really…The patient advisor is educated and vetted, and the committee is educated and vetted, and there’s a liaison person, so, umm, they, they know the rules, they know what to expect. (PP#2).
Empathy and respect for patientsIt just felt like it was the good human thing to do. (HCWP#20).
They were so nice about it (the error) and they were so understanding … she just kept comforting me, she knew, I guess she realized that it affected me really deeply, so, she was really understanding. (HCWP#16)
Barriers to communications and healingThe barrier is essentially the, umm, overriding influence and control of the legal profession on healthcare…. It makes it virtually impossible to talk about what is learned. (HCWP#14)
… If I have to carry their burden for the rest of my life, I think it could wreck me as being the nurse that I am… I think it would just make it way too personal to be able to carry it. (HCWP#7)
I find it hard to meet with families about other people’s errors, usually because when you get to that point it is a really emotional charged situation, so have met with people who are angry, I have met people who are devastated, and that’s hard to be in the receiver end to that, I feel I’m on the receiving end in that instance. (HCWP#20)
HCW perception of patients’ communication needsPeople appreciate honesty and forthrightness. If you are straightforward and honest, and they can see that you are appreciating or understanding that the mistake had some consequences for them and that you regret it. (HCWP#4)
The most important thing is to approach the conversation with a lot of humility…the power of saying “I don’t know” and providing some explanation of what you are going to do about it is a fairly powerful sort of a thing that disarms people. (HCWP#4)
That immediate moment might not be beneficial, they might be in a state of shock and not understanding what you are saying and I guess it depends on the type of situation, case. (HCWP#16)
If they are still in a very high upset level, it’s not going to be helpful for any of the parties, so, yeah, it’s probably, you have to wait at least until all the emotions settle a little bit…I am saying that after those emotions are settled, that’s I guess the best time for having a conversation so you listen and the patient gets to be listened to, because otherwise I think you would be talking against a wall of emotions. (HCWP#19)
And some people don’t want to be included, that’s fine if they don’t want the reminder, it’s almost like it’s a form of PTSD, so you have to be sensitive to that possibility. (HCWP#4)
What HCWs need to healIf you have a manager that you don’t like, you don’t feel comfortable around, that’s going to be a big barrier for sure…So you need to have coworkers and groups that are actually open to discussing this in a non-judgemental fashion. (HCWP#21)
I do remember everybody talked about the way they felt, and that was the major thing to realize that we all felt the same. (HCWP#7)
I guess I kept thinking or I kept trying to remember, ok it is not my fault entirely, I know these things happen and trying to remember all those moments when people just told me it’s ok, it happens to everyone, it’s ok. (HCWP#16)
We should practice those things and not just think that the nurse and the doctor in the heat of the moment are going to do well at it. (HCWP#18)
  • HCW, healthcare worker.