Breaking Bad News Robert Buckmans protocol for letting someone know something that they dont want to hear

Getting StartedGetting Started –Private with Doctor and patient sitting comfortably –How are you feeling right now? –Anyone that the patient would want present?

Finding out how much the patient knows Details are important Details are important What detail would you like to hear? What detail would you like to hear? –Specific or general –Keeps the patient (a person) as the priority What have you already been told? What have you already been told?

Sharing the informationSharing the information Have agenda in mind before sit down Have agenda in mind before sit down –Topics could include: Diagnosis Diagnosis Treatment Treatment Prognosis Prognosis Support or Coping Support or Coping –Focus will be on one or two –Information should be given in small chunks –Long lectures are overwhelming and confusing –Translate medical terms and avoid teaching pathophysiology

Responding to the patients feelings Must respond properly Must respond properly –Caring physician –Acknowledge the reaction –Go with reaction –Could you tell me a bit about what you are feeling?

Plan follow-throughPlan follow-through Outline a step-by-step plan that will be carried out in the patients system of health care Outline a step-by-step plan that will be carried out in the patients system of health care Be explicit about the next contact with the patient Be explicit about the next contact with the patient Arrange a means of contact if needed Arrange a means of contact if needed –Probably will (questions/concerns)