L5: Breaking bad news and disclosing medical errors Flashcards
1
Q
what is bad news
A
serious and adverse impact on patients view of the future
2
Q
focus on
A
not just the medical reality but the impact on the patient
3
Q
SPIKES
A
setting perception invitation knowledge emotions summary/strategy
4
Q
non-verbal signals
A
shoulders - relaxed shoulder, down
eye contact- unless the patient is crying or angry
5
Q
pitfalls of bad news
A
poor setting or distraction
assuming rather than checking patients understanding
giving news in hurry
responding to emotions with facts
6
Q
death of a patient- talking to relative
A
1) begin with the relatives perception
2) telling the medical story of the events
3) dont forget that the relative needs EXTRA time to provess the events, use empathy!
4) dont let the relative alone
7
Q
CONES (for disclosing medical errors)
A
context opening narrative emotions strategy
8
Q
pitfalls of disclosing medical error
A
not disclosing the error undue delay assigning it to a junior staff assigning blame, offering excueses false reassurances
