| • |
Confirm the medical facts of the case.
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| • |
Ensure that all the needed information is available. If this
is an unfamiliar task, find a colleague who will play the part
of patient so that you can practice, preferably using a tape-recorder,
so that you can play it back later. Remember that you should
use a patient led approach, so you will be responding to their
concerns rather than using a rehearsed "script".
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| • |
Try to create an environment in which the patient is comfortable.
In the ward, this may be his/her bed-space with the curtains
drawn, rather than an office, which may be strange to them.
|
| • |
Ensure privacy and openness. A desk between you and the patient
will act as a barrier. Have a box of tissues which you can offer
if there are tears.
|
| • |
Negotiate the time you have for the interview. It will help
the patient to know that you are allowing adequate time, but
will also encourage them to prioritize their concerns.
|
| • |
Make every effort to prevent interruptions. Block telephone
calls, give your bleep to a colleague or secretary and use a
"Do not disturb" notice if you are using a general office. Negotiate
with colleagues so that they will not interrupt you.
|
| • |
Ask the patient who, if anyone, they would like to have with
them. This need not be the official "Next of kin", but a same
sex friend, a confidant, or a specific member of the health
care team.
|
| • |
If the patient is a child under 16 yrs the information about
disease, prognosis and treatment, belongs to the parents. Negotiate
if they are happy for the child to be present, as this will
encourage openness and avoid later collusion. If not, ensure
that another member of staff takes care of the child during
the consultation.
|
| • |
Which of these do you think is most appropriate?
|
| • |
Describe how you would reach this decision. |
A
time to share
know or suspect?
