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Open Disclosure

Role Play – Open Disclosure 2
Nurse     You are the community-based RN looking after Mrs Garland, a 59-year woman with type 2 diabetes who has an ulcerated right heel (approx. 50mm diameter). Mrs Garland also appears to be very lonely, and has told you on a number of occasions that she looks forward to your visits. You see Mrs Garland 2/7 and cleanse and apply a hydrofibre dressing to the wound every visit.
However, during your current visit, you notice that the wound has a large amount of exudate issuing from it. You ask Mrs Garland if she has noticed this, and she informs you that she was just about to mention this to you. You then check your treatment plan from the GP and realise that you have been overly changing the dressing, as it was meant to be changed weekly and not second daily. You feel dreadful, as you were unfamiliar with this new type of dressing and are now in the position of having to tell both Mrs Garland and her GP that you have made a mistake.
You have 10 minutes to explain and discuss the situation with Mrs Garland.

Duty of care
Open disclosure policy
Practice/Registration issues
Therapeutic relationship
Therapeutic use of self


Role Play – Open Disclosure 2
Client You are 59-year old Judy Garland and you have an ulcer on your right foot that has been causing you problems for about two months. Your GP tried to fix the ulcer in the surgery, but now it has got so bad that you can’t drive. The community nurse has been coming to your home for about 2-weeks and visits every second day to change your dressing. You get on well with this nurse, as you have been lonely since you and your husband divorced a few months ago.
However, over the last few days, you have noticed that the skin around the ulcer looks very red. You also feel that your ulcer is getting worse, as it has been weeping more in the last week or so and it also smells unpleasant. Your leg hurts and you aren’t able to get around and do all the things that you need to. You will tell the nurse of this when she comes to visit today.

Lack of knowledge
Impaired mobility
Social interruption



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