Year 2 Dec. Formative Flashcards
Define what is meant by “bad news”?
News that negatively alters the patient’s (or relative’s) view of the future
Doctors may falsely reassure the patient or normalise the consequences of a diagnosis in order to avoid the stress of breaking bad news. What is this called?
Distancing
What are the steps of the ABCDE mnemonic for breaking bad news?
A - advance preparation B - build a relationship C - communicate well D - deal with patient reactions E - encourage and validate emotions
What are the steps of the SPIKES mnemonic for breaking bad news?
S - setting up P - perception I - invitation K - knowledge E - emotions S - strategy/summary
What strategies can be used to deal with patient’s anger?
- recognise/acknowledge the emotion
- remain calm
- do not dismiss the emotion
- apologise / express sympathy
What are the possible immediate manifestations of grief?
- anger
- denial
- fluctuating mood
- depression
- preoccupation
- agitation
- blame
- bargaining
- guilt
- numbness
What information might you gain from a home visit that you might not get from an appointment in surgery?
- is the patient caring for themselves?
- is the patient caring for others?
- do they have support from informal carers?
- indication of SES
- medication management
- do they have adequate mobility around their home?
- is the patient tending to their personal hygiene?
- any signs/indication of abuse
What services might social services provide to a patient who is housebound?
- give information on how to access help and support
- assess whether the patient requires any help with their ADLs
- assess whether the patient is eligible for any financial support
- assess whether the home is an appropriate place for the patient to live / whether any modifications are necessary
- look out for signs of neglect
What services might distract nurses provide to a patient who is housebound?
- assess the need for nursing support
- assess whether OT support is necessary
- assess medication management e.g. flag need for dosset box etc
- discuss patient’s nursing needs at MDT meetings
- administer immunisations
Informal carers may experience adverse effects on their mental and physical health as a result of their caring role. What reasons might there be for this?
- physically exhausted from helping another person with their ADLs
- isolation and carer burden may lead to depression
- less time to attend to their own health needs
- less likely to be in paid employment if providing informal care: poverty can impact on mental and physical health
Define the legal duty of care
A legal obligation on one party to take care to prevent the harm suffered by another
Do doctors have a legal duty of care to patient’s when they are not at work?
- outside of their work environment, doctors do not generally have a legal duty of care - they are not obliged to act as “good Samaritans”
- HOWEVER, if they state they are a doctor or act as if they are a doctor then they take on a legal duty of care for the patient
What three things must be proven for a successful claim of negligence relating to diagnosis or treatment?
- causation
- duty
- breach
How might causation be proved in a negligence claim?
- “but for” test, the claimant must show that , but for the defendants negligence, they would not have come to harm
- the claimant may argue that on the “balance of probabilities” the negligent action caused the harm - requires the claimant to show the harm was more likely to have occurred due to the negligent actions than not
Baby vax: 8 weeks
- 6 in 1: Diptheria, Tetanus, Polio, Pertussis, Hib, Hep B
- Pneumococcal
- Rotavirus
- Men B
