- Nurse: “Hi Betty, Frank’s asked me to come and speak to you about what the doctor has just said.”
Betty “Thanks it’s good to get the chance to talk to you away from the noise of that machine”
Key Point: Find a quiet private environment to discuss bad news - Nurse: “how do you think Frank is?”
Betty “He doesn’t seem to be recovering as well as he did when he had his heart attack”
Key Point: Check understanding - Nurse: “let me explain why that is; Frank has acute heart failure which means his heart isn’t pumping effectively and I’ve had a discussion with a number of colleagues about Frank’s ongoing treatment options”
Betty “ do whatever will make him better”
Key Point: Determine how much the patient wants to participate in decision-making - Nurse: “the treatment options available will support his heart but will not cure his heart problems”
Betty “ok can you tell me what these options are”
Key Point: Discuss treatment options so that the patient understands the implications
Pulse point
In this situation the nurse may communicate patient specific issues to a number of colleagues, normally known as the Multi-disciplinary Team (MDT). MDTs will vary from area to area but are likely to include a cardiologist, specialist nurse, interventionalist, psychologist and palliative care professional. The MDTs will also consider the patient and their family or carers as central to any decision making.
Page last reviewed: 28 Jul 2020
