NMC Professional Duty of Candour 2 — Questions and Answers
Question 1: Under the NMC duty of candour, what must a nurse do FIRST when a patient safety incident occurs?
- File an internal incident report before speaking to the patient
- Inform the patient or their representative as soon as practicable (Correct answer)
- Consult a senior colleague before disclosing anything
- Wait for a formal investigation to conclude before disclosure
Correct answer: Inform the patient or their representative as soon as practicable
The NMC requires nurses to inform the patient or their representative as soon as practicable after recognizing a notifiable safety incident.
Question 2: A nurse accidentally administers the wrong dose of a medication but the patient appears unharmed. What should the nurse do?
- Document it quietly and monitor the patient without disclosure
- Tell the patient what happened, apologize, and follow incident reporting procedures (Correct answer)
- Only disclose if the patient develops symptoms
- Report only to the charge nurse and let management decide
Correct answer: Tell the patient what happened, apologize, and follow incident reporting procedures
Even when no harm is immediately apparent, the NMC duty of candour requires disclosure, an apology, and incident reporting.
Question 3: Which NMC document explicitly outlines the professional duty of candour for nurses and midwives?
- The Mental Capacity Act 2005
- Raising Concerns at Work guidance
- The NMC Code (2015, updated 2018) (Correct answer)
- The Health and Social Care Act 2012
Correct answer: The NMC Code (2015, updated 2018)
The NMC Code sets out the professional duty of candour as a binding standard for all registered nurses and midwives.
Question 4: An apology given as part of the duty of candour is best described as:
- An admission of legal liability that can be used in court
- A sincere expression of sorrow or regret that does not constitute an admission of liability (Correct answer)
- A formal disciplinary statement required before any investigation
- A conditional statement that must be approved by the hospital's legal team
Correct answer: A sincere expression of sorrow or regret that does not constitute an admission of liability
Under the duty of candour framework, an apology is an expression of regret and empathy, not a legal admission of liability.
Question 5: What is the PRIMARY purpose of the professional duty of candour according to the NMC?
- To protect healthcare organizations from litigation
- To enable regulatory bodies to sanction negligent nurses
- To maintain trust between healthcare professionals and the public (Correct answer)
- To satisfy insurance requirements for clinical incidents
Correct answer: To maintain trust between healthcare professionals and the public
The duty of candour exists to uphold trust between healthcare professionals and the public by fostering openness when things go wrong.
Question 6: A midwife makes an error during labor that causes a baby to require additional monitoring. The parents ask directly what happened. The midwife should:
- Explain that the case is under review and decline to comment
- Be open and honest about what occurred, offer an apology, and explain next steps (Correct answer)
- Refer all questions to the consultant obstetrician only
- Acknowledge a 'complication' occurred without specifying the error
Correct answer: Be open and honest about what occurred, offer an apology, and explain next steps
Being open and honest with the patient or family, offering an apology, and describing what is being done next fulfills the duty of candour.
Question 7: When is a nurse's personal duty of candour activated?
- Only when a patient makes a formal complaint
- Only when a serious incident is declared by a manager
- Whenever the nurse recognizes that something has gone wrong that could or did harm a patient (Correct answer)
- Only when instructed to disclose by the NMC directly
Correct answer: Whenever the nurse recognizes that something has gone wrong that could or did harm a patient
A nurse's professional duty of candour is activated the moment they recognize that a patient safety incident has occurred or may have caused harm.
NMC Professional Duty of Candour 2
Under the NMC duty of candour, what must a nurse do FIRST when a patient safety incident occurs?