SIX SECRET STEPS FOR BREAKING BAD NEWS IN CSA EXAM!

Hellooo Friend!
Hema Here!

Give me a Biggg Hi 5!

The Thought of Breaking Bad News Always Scares Me :-O

That too in CSA... I can't Imagine!

What about You ??? 

Here again, Dr Kashif Bhatti is sharing his thoughts about how to prepare it for CSA specially for You :-)

He is one of the TOPPERS in our Beautiful Great Yorkshire Deanery in the February 2012 CSA Batch.

Handed over to Kash...Kash..Kash...

Breaking Bad News & CSA!

Breaking Bad News...

When you think about it, is  ‘Breaking Bad News’ breaking news that is potentially upsetting to the patient, or is it breaking news that you, 'the Doctor', considers bad? 

So, therefore, 

Is ‘Breaking Bad News’ about giving diagnoses about Cancer, MS, Alzheimers, Parkinson’s etc., in another words, what WE think is bad... 

Or is it about diagnosing hypertension, diabetes, AF, Chronic cough, etc., which are bad and inconvenient to patients? 

A philosophical point! 

My point is  - Do not assume the level of any news you give to patient will be matched by level the of importance patient gives to it. 

So, in effect, any news that you are giving –
stop and check...

what the patient understands and thinks about it...
And whether they need further support (follow-up, information, groups/charities/societies etc.) to live through it. 

So, to me, diabetes would be ‘bad news’...

So I would expect someone to break it to me… well and understanding this. 

Philosophy is over! 

Now, how do you ‘Break Bad News’? 
With as little information as possible! 

This is an oxymoron, but think about it.

CSA is about Real-life Quality Consultation.

Breaking Bad News Should Be a High-Quality Communication Task.

There are general rules about breaking bad news. 

This is a good presentation:

http://www.youtube.com/watch?v=ItC68Pdnpk4&feature=player_embedded 

Another good site for some ‘key words’ (for all of you CSA ‘key words’ lovers!): 

http://www.youtube.com/watch?v=p7daAlRjl3M&feature=fvwrel

Two more useful links:

http://www.nytimes.com/2006/01/10/health/10teac.html?pagewanted=all

http://www.scribd.com/doc/53749703/Breaking-Bad-News

SIX SECRET STEPS FOR BREAKING BAD NEWS!

The Approach for Everyday/CSA - 

1. Be Slow and Deliberate.

2. Give warning shots, Pause – ask them if they know where you are going with the results/news/tone of voice etc. The patient may already be thinking of the same diagnosis – let them say it. It is empowering.

3. Let the news sink in…

4. State your desire to provide information and help with any questions/ symptoms/ problems they have for long-term, and then give them space to think/verbalize anything.

5. Try to summarize and tidy-up any bits, such as ‘I have to refer you for.., or I have to arrange this..’ near the end of 10 minutes...

6. Finally, safety net and have a robust follow-up plan that includes being available by telephone or face-to-face for questions, symptoms, concerns.

Remember: Be the doctor your patient wants you to be! 

Be Flexible and Change Your Approach...Based upon how your Patient is responding...

A patient who knows it all, wants a practical approach, not you holding there hand for 10 minutes! 

Try to be expedient when you give news – any news – as patients are waiting to hear the reports.

Explore quickly in your first minute the context of the tests (unless they state it themselves) by apologizing that you need to make sense of the results as you have never met the patient before, and then inform them.

Think how you would want the news or any test result yourself – quickly, I imagine.

Be Positive, Enjoy!
  Kash.
(Dr Kashif Bhatti).

Hiii Friend! 

Me Again :-)
Thank you so much, Kash.

My Bonus Tip is to Practise, Practise, Practise...
Observe Your Seniors Doing IT...

To Your Success,
Hema xoxo.


P.S.

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