Communicating effectively with patients to optimize their care
Wrong side surgery
Type of activity: Text case
This brief text case describes a situation in which a male patient undergoes a wrong-sided surgical procedure. The facilitation questions and suggestions to faculty focus on helping learners to plan and follow up a disclosure discussion.
It is a busy day in the operating room. In the recovery room, a nurse identifies that a 54-year-old male who was scheduled for a left-sided nephrectomy, in fact, had the right kidney removed by the urologist.
The nurse immediately follows up with the urologist involved. The urologist asks for advice on how to disclose this apparent wrong-sided surgery. The succession of events that led to the removal of the wrong kidney is not yet known.
- What advice would you give to the urologist about disclosing the incident (accident in Québec) to the patient, including what should be said, by whom, and when? (See Suggestions to faculty.)
Suggestions to faculty
Have learners form into groups of 3 or 4 to create a detailed plan for disclosure using the disclosure road map. The plan should include details on how they will address the patient's clinical, emotional, and information needs; who will be involved in the disclosure discussion; and what information will be shared with the patient. Have learners implement their respective plans by role-playing the initial disclosure discussion. Ask learners to plan for the possibility of strong emotional responses.
As follow-up, ask learners to consider how they would conduct post-analysis disclosure.
CanMEDS: Medical Expert,