5 minutes preparation:
1. Decide need to ask for family members/friends to be in the room? - Bad news vs the rest
If bad news....
2. Warm up: How is the patients since last seen?
3. Current understanding - What is the level of understanding? - of the condition of patients/ relatives/ of the test done - reasons)
4. Perspective - What do the patient think is the problem? What is the expectation?
5. Shoot - warning shot, silence and shoot the news, and silence.
7. Permission to continue.... Explain the diagnosis/ ever heard before / anyone in family/friends had it?
8. Expect patient to ask - why me? - Usually unknown.
9. Expect anger - why no picked up early? - Not entirely sure what has transparent between you and the GP, it seems to be this is reasonable time line. Difficult to diagnose with non-specific symptoms. etc etc. Goreng.
10. Investigation further. Referral to specialist team
11. Treatment modalities
13. How are you feeling about this news?
14. What is going through your mind?
15. Anything I can help?
16. Probe social history - talk around the family/plans to tell them/offer appointments together and discuss with family members together. Information leaflets. Society to talk to.
17. How to go back? Offer taxi.
18. Next appointment. See consultant. Ask more questions.