Sorry seems to be the hardest word. Especially when it comes to the recent and terribly sad story of a young man with learning disabilities who experienced an untimely and preventable death. Many are campaigning for the truth....an explanation..an apology. Should they really have to?
How do we say sorry in the NHS? Do we get it right? or are we still chipping away at the wall of silence?
One thing we know for sure is that 'Good people do bad things'. When we do get things wrong, it is hard to imagine, but we also go through our own stages of grief. We are angry with ourselves as clinicians, we ruminate, deny, accuse, and hopefully accept and learn from our mistakes in a productive way. We grow.
The challenge is to inquire, ask questions, find out why things went wrong and investigate concerns without seeming punitive or placing blame. The focus must always be to learn....Realistically this is not a fast and easy path to take. This is especially true when a media onslaught can distract the #NHS team from the task at hand.
So how do we say sorry?
One young academic has made valuable discoveries whilst analysing texts such as the infamous Katrina Percy letter, the follow-up letter from Simon Waugh, the briefing note to Monitor , and the public statement that was issued after the Verita report was published. Statements referring to positive events, such as improvements to services, previous good care etc., and the negative events such as patient death and the general failings were analysed.
Findings from author @AllyRgrs:
- Passive sentences (backgrounding responsibility) were more common in statements regarding positive events such as ‘improvements’, and responsibility seemed to be suggested to fall on Southern Health as an organisation.
- When the responsible participant was removed, the responsibility could almost always be inferred from the surrounding context, and the participant suggested to be responsible was generally Southern Health as a whole in positive statements, but staff at the unit in negative ones. This seemed to create a divide between the ‘good’ organisation and the ‘bad’ staff.
- Southern Health was most frequently shown to be doing things to something else, such as improvements, whereas staff were always positioned behind something else which backgrounded their involvement in actions.
- Inanimate nouns such as ‘investigation’ were also often shown to be responsible for actions rather than explicitly naming who was driving these processes, further hiding personal responsibility.
- Inanimate nouns often ‘helped’ Southern Health in positive events, but ‘revealed’ information to Southern Health in negative events. This frames Southern Health as being dependent on these inanimate nouns, and reduces their responsibility for actions.
- Staff were often shown to be responsible for ‘failings’, whereas Southern Health was shown to be responsible for a greater variety of actions, again creating a divide between ‘good’ Southern Health and ‘bad’ staff.
We were fascinated by these findings, which clearly show that we are not yet saying sorry in the right way. Any apology should be utterly sincere. We may not be instantly forgiven, acknowledged or even have our apologies accepted, but we must persist in being, and saying sorry. Along with this we have a duty to learn and grown from any incidents for which we played part in.
Lastly, we must forgive and be kind to ourselves and each other.