Frequently Tested Communication skills: Drug error, Breaking bad news, Procedure explanation…

ALWAYS LOOK FOR THE CLUES IN THE SCENARIO, WHETHER ITS A CORONER POSTMORTEM OR NOT.. SEE THE CLUES BELOW..

We do it if:

• If someone dies suddenly within 24 hrs of admission.
• If someone dies and is not attended by doctor within last 14 days of his life.
• If someone is dies in operation or in recovery.
• If someone dies in fight, industry. police, jail, poisoning, drowning.

ALWAYS STOP THE MEDICINE OR DRIVING OR ANYTHING THAT IS CAUSING THE PATIENT PROBLEM.

Introduction:

Hello Good Morning.. I am Dr Imad, one of doctors working in ******** department .. Are you Mr/Miss *****… Nice to meet you. I understand that we are here today to ***** .. is that correct? Could you tell me, how much do you know about ****** Could you tell me Whats going on with you.. Before i proceed further i would like to know what you expect to achieve from todays discussion.

Tell the name of disease or PROCEDURE or any jargon mention in the scenario.. then ask. Have you heard about the disease.

Note: Add following phrase:

• (If breaking bad news or counseling for chronic illness): Do you want anyone else to attend the discussion .. (Absolutely not in cases of confidentiality like Counseling for HIV).

END:

• **Social history and Pregnancy. (**Pills period pregnancy Job smoking alcohol job Impact)
• Provide Help with leaflets, I recap,.. Always discuss with the consultant and book follow up appointment.
• If you are unable to solve the problem, always say,.. I will arrange a meeting with my consultant.

<aside> 📣 Social History: SAJID - LT: Smoking, Alcohol, Job, Impact, Driving, Living, Travel.

</aside>

Phrases that will help:

• Do you mind if i take a few notes and let me assure you these notes will remain confidential.

• When you are talking to someone else (regarding patient): I hope Mr bill has given permission to discuss, (CONFIDENTIALITY)

• When patient shares a problem: I am sorry to hear that, i will try to solve it ….. I can appreciate your feelings.

• When explaining anything to patient: Are U with me? Are u getting me ? Does it make any sense for you? Do you want me to tell more?

  • This is not the last time we are having this conversation, i know you must be having many thoughts going on in your mind.. we can have discussion in our follow up discussion.

• WARNING SHOT: I'm deeply sorry to share some difficult news with you.. SOMETHING UNEXPECTED HAS HAPPENED

• We were not suspecting this but we have found a concerning news for you. I'm deeply sorry to have to share some difficult news with you. After reviewing your test results and medical history, it's become clear that you have a condition called **** … I know this might be overwhelming to hear (Breaking Bad news) — Disease explanation, death or palliative / end of life care.. When you cant do anything.

• Its not curable but its manageable.. I regret to tell you, its not curable, but i can assure you with your effort and our help, you will be able to live a near normal life. (FOR INCURABLE DISEASE)

• Fluid filled sacks that hamper kidney functions and they increase with time: Cysts (ADPKD)

• If we don't know, how a disease is genetically transferred like autosomal domin or recessive, then How to proceed? This disease do run in the family, but right now i don't know , but i will confirm it from my consultant and come back to you. (GENETIC TRANSMISSION OF DISEASE)

• IF A PATIENT ASK SOMETHING ABOUT FUTURE THINGS: If Patient ask about when my kidneys fail or when i will be wheel chair bound: Disease behaves differently in different people, nobody can predict. But I assure you, we are here to support you at each and every stage of your disease.

• If the patient says that i am going to other hospital: Its your right to take second opinion… they will start from the beginning,,, and i am pretty sure, they will tell you the same..

• How to say to STOP DRIVING : At the moment, i will advise you to stop driving and inform DVLA

• don't worry, she is doing well.. We are keeping an eye on her.

• Do you mind if i ask you, why you do not want admission.

May i discuss another sensitive issue, if you don't t t t mind… Did your father expressed any thoughts about organ donation???

Do you know how would your father behave in such a condition like organ donation…

Your father's passing presents an opportunity to potentially save lives through organ donation. This decision is completely up to you, and there's no pressure.: (Organ donation)

If you agree i will refer you to organ donation team.. There wont be any disfigurement and funeral ceremony wont be delayed at all….

If attendant says, could you give us some time before organ donation: Take your time, we can meet again, please talk with your family members, I will give you hospital contact no..

Unpredictable diseases in PACES: Delirium, Multiple sclerosis, GBS… (say we are not sure how the disease will behave — sometimes patients recover, sometimes they don't t .. time will tell)

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