Communication Flashcards
1
Q
Examples communication
A
TAB: summary
Underperforming colleague
Delirious patient – rapid tranq, negotiate SR
LP: needle phobic, vulnerable, frightened, consent
Breaking bad news: Jew, cauda equina, CXR – mass, wife, no surgery to Israel
Potts puffy tumour; jewish, persuade/negotiate
2
Q
Describe good communication
A
Exchange of information: Active listening (not interrupting), Empathetic => trust, rapport Clear, concise, structured information => reduce error, misunderstanding Adapt communication to audience Help persuade and negotiate with others
3
Q
Underperforming colleague
staff grade, clinical/research fellow
A
New country, 6 years out of work Supervision and training weekdays worried re: on-call Encouraged: c. supervisor: shadow Registrar rota ?ready for on-call: struggling, worried, training atm, ?shadow on call Re-organised on-call
4
Q
Example where you showed empathy
A
Breaking bad news: acute medicine Orthodox Jewish: bilateral leg weakness MRI: Cauda equina – secondary to mass CXR – large mass Spinal surgeons discussed: – did not want surgery, second opinion Patient wanted to discuss further, with wife Symptoms, MRI findings, mass spine and CXR, Requires further investigation Pressure on spine causing symptoms – decompress to improve/prevent Capacity Concern: get to Israel Offered rabi, already organised Upset pressured without listening Reflection: active listening Active listening assuage patient fears - not listening
5
Q
Example where had to defend beliefs/ communication made a difference
A
Orthodox Jewish patient – swelling to head, out of hours Previously aspirate taken, discharged on oral fluclox Return due to culture, Swelling had improved. ENT referral – discharging molar sinus Imp: Potts puffy tumour Plan: admit, IV abx, CT scan +/- surgery Patient nil admitted, Patient feeling better nil IV antibiotics fainted with IV abx – not allergic Comp. – intracranial infection Agreed plan -- wait for wife for IV abx administration – not septic. CT confirmed PPT Did not require surgery Reflection: active listening clear with imp/concerns/comp persuade and negotiate
6
Q
Communication mistake:
A
Beriplex (PCC) SBO – theatre – on warfarin PCC requested, prescribed NS to give PCC. NS ?how –instructions Complete WR PCC not given – syringe driver Bolus - would not do it. Asked her to watch me Reflection – closed loop communication
7
Q
Consent a Vulnerable patient:
A
Consent: LP, needlephobic + afraid bleed on brain Organised family member to be there Explained procedure; why we wanted to do it. Pros, cons, alternatives, risks Checked understanding Stop at anytime Crying - Encourage but not lie Competed - unpleasant
