Patient 1 – 82 year old woman Morag Johnston

Video notes

01:02 Don’t assume it is OK to use “mum” but it is usually acceptable if her daughter has used it.

02:40 At this point you may need to consider if you think non verbal support is appropriate or not. Such as leaning forward, offering a tissue or offering a hand on the person’s arm as a comfort. Remember many people would not want physical contact from a stranger but others in this difficult situation may.

04:13 The daughter is very upset. Time is needed for this news to sink in. Wait for sobbing to subside. Nurse offers support.

08:13 This may seem to be a very focused conversation but it is crucial to ensure that the family are aware that the person is dying and is unlikely to survive for more than a few hours. In very acute situations like this it is crucial that all the family are made aware of the reality of the situation quickly but sensitively due to time pressures. There is often no easy way of giving this information.Reflect on this and consider how you find it having conversations with a family in this setting.

• Use of body language is important. Note the open stance of the doctor, leaning slightly forwards. he uses a quiet voice, and speaks in an unrushed manner.
• There is a lot of information to communicate in this discussion – although it’s sometimes best to have several conversations, in this instance the patient is likely to die quickly and so information needs to be compressed into a single meeting.
• Check understanding. Pause after breaking each aspect of bad news. Be clear about the message being delivered i.e. likely to die quite quickly. Use the term ‘dying’ rather than euphemisms.
• Although the doctor starts by using the term ‘your mum’, only use ‘your mum’ if the relative refers to her in this way.