| Course | NUR 659 Healthcare Safety, Just Culture, and Regulation |
|---|---|
| Module | Module 6 |
| Paper type | paper on error disclosure and clinician support programs |
| Length | About 1,040 words, 6 pages |
| Format | APA 7 student paper |
| School | Southern New Hampshire University |
| Program | MSN |
| Updated | September 2026 |
Free sample paper for NUR 659 Module 6
Telling Patients the Truth and Caring for the Clinician Who Erred: A Communication and Resolution Program
[Student Name]
Southern New Hampshire University
NUR 659: Healthcare Safety, Just Culture, and Regulation
Module Six Disclosure Paper
[Instructor Name]
[Date]
Telling Patients the Truth and Caring for the Clinician Who Erred: A Communication and Resolution Program
Every harmful error calls for two conversations. One is with the patient and family, who need to know what happened and what will be done. The other is with the clinician involved, who may be suffering in ways colleagues do not see. Many hospitals handle both poorly: disclosure is delayed or evasive for fear of lawsuits, and clinicians are left alone or treated as suspects. At Westbrook, a composite 220-bed community hospital, the patient harmed in the insulin wrong-patient event recovered, but when her daughter asked what had happened, a physician said only that her sugar had dropped unexpectedly. The nurse involved, meanwhile, told a colleague she was thinking of leaving nursing. This paper designs a communication and resolution program that addresses both. It argues that honest disclosure, offered promptly and supported by a trained team, serves patients and the organization, and that caring for clinicians is part of the same commitment.
What Patients Want
Gallagher et al. (2003) conducted focus groups with patients and physicians about medical errors. The patients in those groups expected to hear about any mistake that had hurt them. They wanted an explicit statement that an error had occurred, an explanation of what happened and why, what would be done about its consequences, what steps would stop it from happening again and an apology. Physicians generally agreed that harmful errors should be disclosed, but many described choosing their words carefully, often avoiding the word error and stopping short of an apology, partly because of fear of legal consequences. The gap between what patients wanted and what physicians said describes exactly what happened to the Westbrook patient's daughter, who received a technically true but evasive answer.
Evidence That Disclosure Does Not Increase Liability
The fear that honesty invites lawsuits has been tested. Kachalia et al. (2010) evaluated the University of Michigan Health System's program, which disclosed errors to patients, apologized, investigated promptly and offered compensation when care had been unreasonable while defending care that had been reasonable. Comparing the periods before and after implementation, they found that the rate of new claims and lawsuits fell, the time to resolve claims shortened and liability costs declined. The study was observational and conducted in one system, so it cannot prove the program caused the changes, but it undermines the assumption that disclosure necessarily increases legal risk. Many hospitals and state programs have since adopted similar communication and resolution approaches.
Designing Disclosure at Westbrook
Westbrook's program will commit to disclosing any unanticipated outcome that causes harm, whether or not an error is certain, with an initial conversation within 24 hours. A disclosure team of trained clinicians and a patient relations specialist will be available at all hours to coach or join the attending clinician. The first conversation will acknowledge what happened in plain language, express regret, explain what is known and what is still being investigated and promise follow-up. Once the investigation confirms an error, a second conversation will include an explicit apology, an explanation of causes and the changes being made. Bills related to the harm will be waived, and the risk management office will review cases for early compensation when care was unreasonable. For the insulin event, a new meeting was held with the patient and her daughter, who were told that the insulin had been meant for another patient, why the safeguards failed, what was being changed and that the hospital was sorry.
The Second Victim
Wu (2000) described clinicians who make serious errors as second victims, arguing that they often suffer guilt, shame and fear, rarely receive support and may respond in ways that harm themselves or future patients, such as defensiveness or leaving practice. Scott et al. (2009) interviewed clinicians after adverse events and described a common trajectory of recovery through six stages: chaos and immediate response to the event, intrusive reflections, efforts to restore personal integrity, enduring the investigation, seeking emotional first aid and finally moving on, which could mean dropping out of the profession, surviving with lingering distress or thriving by drawing meaning from the experience. They found that support from trusted colleagues at the right moments strongly influenced which path clinicians took.
Disclosure conversations will be documented in a standard note that records who was present, what was said and what follow-up was promised, and a patient relations specialist will call the family within a week to answer new questions. Families will be given a single contact person rather than being passed between departments, which patients often describe as the most frustrating part of the aftermath.
Supporting Clinicians at Westbrook
Westbrook will establish a peer support program with trained volunteers from nursing, medicine and pharmacy. When an event causing harm is reported, the manager will contact the peer support coordinator, and a trained peer will reach out to the involved clinician within 24 hours, offering a confidential conversation that focuses on the person rather than the facts of the case. Clinicians will be told what to expect during the investigation, which addresses the stage Scott and colleagues described as enduring the inquisition. Referral to the employee assistance program or mental health professionals will be available for those who need more. The nurse involved in the insulin event was offered a peer supporter, took paid time off, joined the root cause analysis team and has since become a peer supporter herself.
Measuring the Program
The program will track the proportion of harm events with documented disclosure within 24 hours, patient and family feedback on disclosure conversations, the number of claims and lawsuits and time to resolution, peer support contacts and clinician feedback on whether support was helpful. Staff surveys on safety culture will include items on whether staff believe they would be treated fairly and supported after an error.
Conclusion
Patients harmed by errors want the truth, an apology and assurance that others will be protected, and evidence suggests that offering these does not increase legal risk. Clinicians who make errors are harmed too, and timely peer support shapes whether they recover or leave. A communication and resolution program that joins honest disclosure with support for clinicians lets Westbrook serve both people harmed by every serious error.
References
Gallagher, T. H., Waterman, A. D., Ebers, A. G., Fraser, V. J., & Levinson, W. (2003). Patients' and physicians' attitudes regarding the disclosure of medical errors. JAMA, 289(8), 1001-1007. https://doi.org/10.1001/jama.289.8.1001
Kachalia, A., Kaufman, S. R., Boothman, R., Anderson, S., Welch, K., Saint, S., & Rogers, M. A. M. (2010). Liability claims and costs before and after implementation of a medical error disclosure program. Annals of Internal Medicine, 153(4), 213-221. https://doi.org/10.7326/0003-4819-153-4-201008170-00002
Scott, S. D., Hirschinger, L. E., Cox, K. R., McCoig, M., Brandt, J., & Hall, L. W. (2009). The natural history of recovery for the healthcare provider "second victim" after adverse patient events. Quality and Safety in Health Care, 18(5), 325-330. https://doi.org/10.1136/qshc.2009.032870
Wu, A. W. (2000). Medical error: The second victim. BMJ, 320(7237), 726-727. https://doi.org/10.1136/bmj.320.7237.726
What the NUR 659 Module 6 instructions ask for
Disclosure papers in NUR 659 usually ask you to examine how organizations should communicate with patients after errors, often including support for the clinicians involved, and to propose a program or policy. Expect to review evidence on patient expectations and legal outcomes, describe the elements of disclosure and plan implementation with measures. A length of about five pages in APA 7 is common. State what disclosure should include, based on what patients say they want, address the fear of liability with evidence and its limits, describe who will conduct disclosure and how they will be trained, set time standards, plan support for clinicians grounded in research on their recovery and measure both patient and staff experience.
How this NUR 659 Module 6 disclosure paper example is built
This paper builds a communication and resolution program after a composite hospital's insulin error, where the family received an evasive explanation and the nurse considered leaving. The Gallagher focus groups define what patients want, and the Kachalia evaluation of the Michigan program shows fewer claims and lower costs after disclosure. The program commits to disclosure within 24 hours with a trained team and a second conversation with apology. Wu's second victim concept and Scott's six recovery stages shape peer support within 24 hours, and the nurse's recovery to becoming a peer supporter is described. Families receive one contact person and a follow-up call within a week. Apology comes once facts are confirmed.
Where the NUR 659 Module 6 rubric puts the points
Grading of disclosure papers commonly weighs the use of evidence on patient expectations and legal outcomes, the completeness of disclosure elements, attention to clinician support, the practicality of the program, measurement and APA 7 writing. Top-band papers define disclosure content from patient research, present liability evidence with its limitations and plan training and time standards. Graders reward programs that integrate disclosure and clinician support and that measure experience from both sides. Describing how the program would have changed an actual event shows applied understanding that reviewers value. Documenting disclosure and assigning a single family contact shows practical planning that graders reward. Accurate statements about study limits help too.
NUR 659 Module 6 help: the mistakes that cost points
Disclosure papers lose points when disclosure is described vaguely, when liability fears are dismissed without evidence or accepted without question, when no one is trained to conduct conversations or when clinician support is omitted. Another gap is measuring only whether disclosure happened, not how it was experienced. Define disclosure content, address liability with evidence, train a team, set time standards, plan peer support and measure patient and staff experience. If your paper focuses on disclosure in a specific setting, such as pediatrics or outpatient care, or on apology laws, send it with your NUR 659 prompt so the program fits. Give the family one contact person.
Get NUR 659 Module 6 written to your instructions
Describe the event or program in your NUR 659 assignment and attach the rubric. Your paper will define disclosure from patient research, address liability with evidence, design training and time standards and add clinician support, within 24 to 48 hours, free the first time. The paper above is an original model document written by our desk, not a submitted student paper and not an official Southern New Hampshire University document.
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NUR 659 Module 6 questions, answered
Where can I find a free NUR 659 Module 6 Disclosure Paper sample?
This page carries the full paper: disclosing an error, what patients want, evidence from the Michigan program and peer support for the second victim.
What do patients want after a medical error?
An explicit statement that an error occurred, an explanation, information on how effects will be addressed and recurrence prevented and an apology.
Does disclosing errors increase lawsuits?
The University of Michigan's program was followed by fewer claims and lawsuits, faster resolution and lower costs, though the study was observational.
What is a second victim?
A clinician who suffers guilt, shame and distress after being involved in an error that harms a patient.
What are the stages of second victim recovery?
Chaos, intrusive reflections, restoring integrity, enduring the inquiry, seeking emotional first aid and moving on by dropping out, surviving or thriving.