Derm - breaking bad news Flashcards Preview

Clinical skills Yr2 > Derm - breaking bad news > Flashcards

Flashcards in Derm - breaking bad news Deck (10):
1

Define what breslow thickness is and whats it used for

Breslow's depth, used as a prognostic factor in melanoma of the skin. It is a description of how deeply tumor cells have invaded. Measures form the Granular layer down to the deepest cancerous cell

2

What is the Buckman 6 step protocol used for ?

Breaking bad news 

 

3

What is involved in step 1 of Buckman 6 step protocol ?

Getting Started

• Getting the physical context right
• Where?
• Who should be there?
• Starting off

4

What is involved in step 2 of Buckman 6 step protocol ?

Finding out how much the patient knows

5

What is involved in step 3 of Buckman 6 step protocol ?

Finding out how much the patient wants to know

6

What is involved in step 4 of Buckman 6 step protocol ?

Sharing the information

• Decide on your agenda (diagnosis/treatment
plan/prognosis/support)
• Start from the patient’s starting point
• Give information in small chunks
• The warning shot - if appropriate 
• Use simple English, not jargon
• Check frequently that the patient has understood and
clarify any points
• Listen for your patient’s agenda, concerns and anxieties
• Try to blend your agenda with the patient’s

7

What is involved in step 5 of Buckman 6 step protocol ?

Responding to patient’s feelings

• Identify and acknowledge the patient’s reaction

8

What is involved in step 6 of Buckman 6 step protocol ?

Planning and follow through

• Organising and planning
• Making a contract and following through

9

What should you do before giving the patient their results and if need be following the Buckman 6 step protocol ?

Take a quick focused history to establish a rapport, learn about home circumstances e.g. if support needs to be put in place. Establish baseline for patients knowledge about the condition. Relevant clinical info.

10

What are the main areas in a focused history ?

  • Short history of presenting complaint
  • ▪ Relevant Past medical history
  • ▪ Relevant Drug history / allergies
  • ▪ Relevant Social / Family history
  • ICE
  • Including what have they been told already