SCA / RCA Flanagan's two approaches to breaking bad news (in brief)

Описание: Learn more on our RCA course. https://www.pennine-gp-training.co.uk.... Two common BBN situations requiring different approaches to the consultation. Have a look at our CSA cases and practice BBN in your CSA groups https://www.pennine-gp-training.co.uk...

Not expecting bad news or little anxiety around a result
 Welcome the patient
 Start with the usual open question
 Find out why the test was organised
 What was said at the time of the test
 What has happened since
 Find out about them as a person
 The warning shot
 PAUSE – do not talk until after they do
 Succinctly deliver the bad news
 PAUSE – do not talk until after they do
 Allow time for emotion
 Show empathy
 Allow time for the bad news ‘to sink in’
 Answer any questions they may have, as best you can
 Explore SPICE and what happens next
 Agree what you and the patient may need to do before review
 Arrange review (soon)
 Summarise before they go

 
Very anxious about a result
 Welcome
 Cue led approach to the opening statement
 Patient anxiety around an anticipated result can paralyse the consultation – there will be verbal and non-verbal cues
 You need a different approach
 You cannot draw out the consultation asking all the background questions
 Explain "I can see you are very anxious about the result. Normally I would find out about what lead up to the test and what happened next and find out about you. But I can see you are really worried. Let me give you the result and we can sort that out afterwards."
 The warning shot
 PAUSE – do not talk until after they do
 Succinctly deliver the bad news
 PAUSE – do not talk until after they do
 Allow time for emotion
 Show empathy
 Ask any background questions (SPICE)
 Agree what you and the patient may need to do before review
 Arrange review (soon)
 Summarise before they go
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