Thursday, 19 April 2007

Breaking Bad News

Right, it's time for breaking news. Breaking bad news, that is.

(Note from your friendly neighbourhood slacker: You can simply read the bold, coloured, numbered points and skip the rest)

1. Do it in a private place
And by this, we don't mean the janitor's closet. Don't break bad news right in the corridor of the hospital, or in front of a roomful of people. Take the patient aside, bring them to your office (if you are lucky enough to have one), or to an empty room.

2. As soon as possible
Don't wait til you receive a call from the nearest mental hospital stating that your patient has just been admitted due to a nervous breakdown thanks to waiting for ten days for that ominous phone call about whether they tested positive or not. ASAP people. In this world, nobody likes waiting.

3. Both parents together
When breaking bad news regarding children, don't give part A to Dad and part B to Mum. Get them both together, and impart your news to them then.

4. In clear and appropriate language
Don't speak Greek. And don't rattle off medical jargon just because you know your stuff, show off! Explain in clear and concise everyday English Language, as how you would explain it to your grandparents, or parents, who are NOT in the medical field, mind you. And by everyday English Language, we would think it would exclude words like 'dude', 'stuff', 'uh', 'erm' and 'you know'.

5. Appropriate emotions
Don't go in there with a big grin on your face and say, "Sorry matey, seems like you've got CF afterall!" 'Nuff said.

6. Give time for the patient (and parents or other caregivers/loved ones) to ask questions
You are not going to liftoff in 10 seconds to a russian space station. Don't rush through your news and then leave. That self-directed latte can wait!

7. Answer questions in an empathic and non-judgmental manner
I suppose we can all be trusted to behave like the fine medical students we are, right? Right?!

8. Provide supplementary written material (when possible)
Fact: If all else fails i.e. you suddenly have a temporary mindwipe thanks to that all-nighter you pulled before the OSCE, remember this point, and you will be fine. Examples of supplementary written material would be brochures, flyers, booklets, what not. In these days, the supplementary material would also extend to informative websites. NOT wikipedia.org, mind you (no offense to the kind folks who contribute to it).

9. Follow-up consultation for soon after
Fact: very little (only about 10%) of the 1st consultation is absorbed by patients/caregivers. They probably heard: "I'm really sorry, but you have tested positive. Blah blah blah... moo...moo...bahh..bahh..." So set up a follow-up consultation for soon after the first visit. Give the patient time for the information to sink in, for them to read through your supp. written material, and come up with other questions.

1 comment:

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