Role play Flashcards
How should you go about breaking bad news to someone
. First I’d make sure that I’ve revised all the information about the case before I speak to the patient or the family to make sure I’m able to answer any questions they have
. I’d start by introducing myself “ Hello I’m doctor Rionach and I was wondering if we could have a conversation about your dad?”
. Then I’d bring them to a quiet area with no interruptions and I’d ask if they are ready to have quite a difficult conversation. I’d also make sure to have enough time to talk with them so I don’t have to rush off.
. I’d explain the case to them in a gentle manner
. “Do you understand what I’ve just told you?” I know this can be quite difficult to hear. Do you have any questions?
. Then I’d ask if they want me to stay with them for a while until they feel alright, or if they would like some alone time to process it.
An elderly man has just been diagnosed with Alzheimer’s and has spoken to you about how he feels there is a big stigma around it and that he is scared of being a burden to his family and the NHS.
He starts crying what do you do
First I’d make sure we were in a private and quiet place with no interruptions at this moment in time. I’d also make sure to not be rushed so I can support him without having to leave him feeling like this.
‘This must be a very hard and confusing time for you but I need you to know that you are supported by us and by your family’. Do you want to talk to me about what you’re feeling? Do you have any questions.
Dementia is not a burden because this is what the NHS is for, we are more than happy to support you in this journey as it is our job and it is situations like these that inspire new doctors every day to research and come to help the NHS.
There are new technological advancements every day, and there are many scientists around the world working on a way to help prevent or slow down Alzheimer’s.
I’d recommend you join this support group called Alzheimers society, where there are people going through the exact same situation as you, and you can talk to them about how you’re feeling and I’m sure they’d understand.
Over the years we’ve learnt a lot more about dementia and how it works and society is less judgemental about Alzheimers than before so there is definitely less of a stigma.
What is the best way to break bad news to a patient
SPIKES TECHNIQUE
Setting
Preparation
Invitation
Knowledge
Empathy and exploration
Summary and strategy
Mentally prepare for the interaction, and go over all notes about the condition so you are fully educated about the topic to answer any questions the patient has.
Locate a good setting with minimal interruptions, for example silencing pager.
Make sure any family members that need to be there are present.
Find out what the patient wants from the interaction: Do you want me to tell you about the full details of your condition? If this condition is serious do you want to know? If not who do you want me to tell?
I am really sorry to have to tell you this… Or unfortunately the tests showed…
Show empathy and ask questions such as ‘Do you understand?” or ‘ Do you have any questions’ or even ‘do you want to repeat it back to me so I can make sure you understand’
Strong reactions are normal so acknowledge how they must be feeling ‘you must be feeling very confused and worried’
I wish the news were different
Ill do whatever I can to help you
It is the unknown that increases anxiety so recommend a schedule with goals.
Set up a plan for treatment or a support group
Ask them if they’re ready to discuss the next steps
