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MRCPCH Communication station - Coggle Diagram
MRCPCH Communication station
Explanation
New diagnosis
New/escalation of treatment
Establish whether parents on the same page in terms of their child's clinical status
Establish whether parents are in agreement with the new plan
Ensure to address risk/benefit
Breaking bad news
Use information "leaking", eg
As you know, X came to us unwell
PAUSE
We think he has X and we have been treating him as such
PAUSE
Unfortunately, despite what we have been doing, he is showing signs of worsening
PAUSE
You may noted that X
PAUSE
Y
PAUSE
Z
PAUSE
What we think we now need to do is.....XYZ
DON'T SAY: "I know how you feel". Better is to say, "I can't even begin to imagine how you must be feeling right now
Offer somebody else to be with them
If a parent asks, "is my child going to die", a nice phrase to use is "we are concerned that he/she is very unwell and that they may not make it home"
Consent
Eg. contraception and counselling of such
Confidentiality exxplanation
Check age of partner, that relationship is consensual
Advise it is often best for young people to involve their parents in the discussion
Critical incident or conflict
Clarify thoughts and feelings
Acknowledge these
Apologise on behalf of the team
Explain that there is the opportunity to make a formal complaint
Signpost to PALS
Explain what you are going to do, agree next steps
Inform them about the Incident Reporting system
Colleague supervision issues
eg late to work
eg low in mood
Ensure you ask about colleague's home life
Be neutral regarding who has raised concerns
Offer to help, train, support
Ask if they can think of anything that needs to be done
Stress the importance of dealing with it, as it is impacting on their work
Education
Why do they want to know about this particular topic?
Was there a particular case that led to this?
If a large topic, as if you can focus on some aspect of it in particular
Check understanding throughout
Offer advice on further sources of information
Ethics
Eg. consent
Chaperone importance
Etc
General
Introduce self, "children's doctor"
Clarify what parents/patients would like to be called
Congratulate if appropriate
Ask if ok to talk now
Clarify what already known
Anything specific would like to know?
Give explanation/answer questions, explaining terms/jargon
Chunk and check
Ask parents to summarise back what they have heard
Give advice on sources of information
Ask if any further questions. Offer to be available to answer any/say they can write them down if they come to them.