BREAKING BAD NEWS :

Attendants keep on

Changing – Speak to Every New Attendant – Answer their Every concern – Don’t Hesitate to communicate with New attendants of a Sick patient – They might turn into your Trouble makers..

Most Important Issue in Communication is

NOT WHAT YOU TALK..

IT IS HOW YOU TALK..

In Every case..

Tell pt all treatment options..

Involve them in Decision Making..

Tell them why you have chosen this option – Which parameters you want to Monitor – And what changes will make you to change management decision..conservative to surgery..

Tell your OP Attendant to allow attendants of so & so sick patients, whenever they come.

Studies showed..

Patients who are more familiar to doctors create Less problems..

Identify patient attendant

who can create problem – Develop rapport with them – Know their name – Communicate with them –

Address their Concerns

80% patients are Noncritical

and Nontroublesome..

20% are Either Critical or Troublesome..Focus on that 20%…

You May have 100 patients to take care..But, for them he is the only patient & it is the only work for them..

YOU MUST GIVE SUFFICIENT

TIME FOR THAT 20% , HOWEVER BUSY YOU MAY BE..

Patients expectations are

Not only from you.

But also From Your staff..

Train them to behave well..

Find few intelligent staff

or Duty doctor..Ask them

to be in constant touch with the sick patient and attendants..

Earn Patient TRUST & CONFIDENCE..

Make their Stay Pleasant..

Just by the way, we blame sick patient poor general condition to his BAD HABITS & Very Late presentation to Doctor ..

In the same way,

when some unexpected thing happen they blame deficiency of services/ staff behaviour..

If they are happy with our attitude, then they usually blame it on God/their karma

Whenever you visit any patient

Greet attendants with smile..

You don’t know which

Case turns out into Emergency

and have an unanticipated

Outcome..

Most important is

UPDATE THEM ABOUT PATIENT CONDITION

REGULARLY..

Tailor the Bad news..

Explain them every bad sign or report from time to time..

Tell ICU staff/ Gateman to give

little relaxation to visit

dying sick patients..

Breaking the Bad news

Should preferably done by

Senior most Doctor..

When you explain

show the File..Show the Bad reports..Explain the Events..

When needed

Show the Facts in Google or Literature and explain them about prognosis of that condition..like survival rates of Decompensated cirrhosis with HRS..

Don’t Face the Mob..

Call Few Key attendants

into separate Room..

Keep sufficient medical

staff on your side..

Speak softly with Proper

Eye contact..If You bend down your Head..They assume that

you made mistake..

Don’t Minimise Severity..

Involve staff who is attending

them regularly( while explaining..)

Use Simple words..

Proper Body language..Lean Forward..

Don’t tell in a Hurry and go..

Give them time to Digest..

Give sufficient pauses..

Let it be a Dialogue –

Not Monologue..

Needs Advanced

Communicative Skills..

Only 7% words..

38 % Tone of Voice

55% Body language..

Listen to attendants..

Allow them to Speak..

Patient Listening itself is

Best way of Communication..

While Breaking Bad News..

Whatever busy your OP may be..Don’t Disclose it in a Hurry..

There will be 5 stages from

attendants side

1. Shock.. Denial..Disbelief

– Convince them by showing them the reports

2. Blame..Anger..Aggressive – Support them, Listen to them, Be calm

3. Bargaining..Empathy (Feel with them for what had happened)and help them to accept reality

4. Depression

5. Acceptance..

Don’t leave them at Stage 1 or 2..Be with the Family silently,

until they reach stage 5

Always Wear Neat Apron..

If you look like Doctor – They respect you like Doctor..

Understand their Feelings..

Tell them that This is One of the complication that can happen at this age or with this disease or comorbidities..

From IIM

Ahmedabad..

who Conducted A Case Study

with Few Doctors and Attendants involved in Mob attacks..

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