8kLAkING 1nL 8AD NLWS

*1he news whlch effecLs Lhe lndlvldual`s vlew abouL hls fuLure
*Should be learnL from senlors or experlence
S schoo| of thoughts
1) 8ps Mode/
lear crlsp lnformaLlon 8uL verLlcal flow ls avolded lnformaLlon accordlng Lo needs of paLlenL
1he bad news should be broken uslng prlnclples of counsellng l and communlcaLlon aLlenL ls
encouraged Lo lnvolve famlly members
lollowlng sLeps should be followed
5teps 1 nvironment
1)xcloslvlty
aLlenL mlsLrusL and anLagonlsm may slmply resulL
% lnvolvemenL of slgnlflcanL oLhers
lf more Lhan one person ls supporLlng paLlenL ask Lhem Lo choose one represenLaLlve lL wllls
suppress Lhe sLress
% SeaLlng arrangemenL
nexL Lo each oLher aL arm`s lengLh ArrangemenL should noL lmparL frlghLenlng lmage of docLor
4% 8e aLLenLlve and calm
MalnLaln eye conLacL 8uL lf paLlenL cry shlfL ur eyes wlLh senslLlvlLy
S% LlsLenlng mode
1 Sllence 2 8epeLlLlon of lasL few words
6% AvallablllLy
ALLend paLlenL ln hls Llme
5tep 2 Potient`s perception
8efore u Lell ask lL allows Lo undersLand gap b/w paLlenL`s condlLlon and hls expecLaLlons lf
paLlenL ls denlal Lry noL Lo comforL hlm ln 1
sL
lnLervlew
5tep l lnvitotion
Ask Lhe paLlenL wheLher he wanLs Lo know or noL
5tep 4 know/edqe
lve warnlng before bad news use language of paLlenL lve lnformaLlon ln small blLs and
respond Lo emoLlons
5tep 5 mpothy
ldenLlfy emoLlons acknowledge and address Lhem uon`L keep away any lnformaLlon lL wlll
make problems
5tep 5ummorite
Summarlzes lnformaLlon and allow Lhe paLlenL Lo ask quesLlons



5tep 7 P/on of oction
whaL role wlll be played by you and your paLlenL ln lssue
2) lndividuo/ited uisc/osure Mode/
ulsclosure accordlng Lo paLlenLs need uevelop LrusL Lakes Llme and skllls ulfferenL paLlenLs
Lake Llme Lo absorb bad news
l) lu// uisc/osure Method
lvlng full lnformaLlon abouL bad news uevelop LrusL allowlng Llme Lo puL affalrs ln order
famlly supporL 8uL lL may frlghLen or confuse paLlenLs or can creaLe negaLlve emoLlonal
consequences
4) Poterno/istic uisc/osure Method
uellver lnformaLlon ln sugar coaLlng by sympaLhy and sharlng emoLlons noL a recommended
one
S% Non D|sc|osure Method
uon`L Lell paLlenL abouL bad news (decepLlon may also be used when necessary) 1radlLlonally adopLed
as paLernallsLlc model 1rusL ls undermlned denlals of opporLunlLy Lo ad[usL opporLunlLles for
helpful lnLervenLlons are losL paLlenLs may recelve wrong lnformaLlon and paLlenL can lose self
conLrol Less Llme consumlng and easler Wldely re[ecLed by docLors
CkISIS MANAGLMLN1
reek word means declslon maklng hlnese has expresslon of danger and opporLunlLy Cr|s|s ls
a serraLlon whlch holds poLenLlal for lndlvldual growLh rovlded LhaL approprlaLe declslons are
made Cr|s|s a perlod of dlsorganlzaLlon and dlsequlllbrlum 8esoluLlon can resulL ln lncrease or
decrease ln person level of worklng or reLurn Lo basellne Powever communlLles may never be
same agaln and can suffer from posL LraumaLlc condlLlon and people may become elasLlc and
hardened causlng poslLlve shlfL ln behavlor called posLLraumaLlc growLh
1ypes
1% Deve|opment Common Lo all ln response Lo sLressful perlod of human maLuraLlon
% S|tuat|ona| where he faces a LraumaLlc evenL whlch could be naLural or manmade
Management has Lhree perlods
a) Lmergency phase b) 8ehablllLaLlon phase c) 8ecovery phase
Iactor to be remembered 1) 1rauma ls never surglcal and medlcal alone sychosoclal
changes also occur whlch are normal reacLlons Lo abnormal slLuaLlons
% vulnerable groups are women chlldren and aged 8uL male are noL lmmune Lo develop
psychosoclal changes
% Larly psychosoclal supporL by Lralners can prevenL psychoLlc morbldlLy sychosoclal and
menLal healLh care should be made and lnLegral parL buL psychoLroplcs should be avolded



4% 8escue workers should be provlded resL and have buddy sysLem and should be ln Louch of
Lhelr famlly
S% up Lo one Lhlrd develop posL LraumaLlc condlLlon buL second dlsasLer can be prevenLed by
proper care
O Do say 1% Lhese are normal reacLlon Lo abnormal slLuaLlon
% l undersLand your feellngs
% lLs noL your faulL ?ou dld your besL
4% l am sorry LhaL Lhls happened
S% 1hlngs wlll geL beLLer and you wlll feel beLLer
O Don't Say 1% lL could be more dangerous % l know [usL now you feel % lL ls besL lf
you sLay busy 4% ?ou can always geL anoLher Lhlng S% ?ou need Lo geL on wlLh your llfe
Commun|cat|on strateg|es
1% uslng sllenceglves person Llme Lo become aware of feellngs
% uslng nonverbal communlcaLloneye conLacL faclal expresslon
% araphraslngundersLandlng empaLhy lnLeresL are conveyed
4% 8eflecLlng feellnghelps person ldenLlfy emoLlons
S% Allowlng expresslon of emoLlons
kIGn1S CI A1ILN1S
1% lnformed consenL abouL dlsease condlLlon and rlsks
% WlLhdraw consenL aL any Llme
% 8efuse research LreaLmenL
4% CbLaln second oplnlon
S% onfldenLlallLy
6% Leave hosplLal aL any Llme
% 8e cared wlLh eLhlcs
% 8equesL medlcal flles from docLors
% CbLaln legal advlce regardlng any maLLer arlslng from LreaLmenL
10% conLacL frlends sollclLors famlly
11% Ask Lo sLay wlLh chlld
1% lnform nurslng sLaff lf he doesn'L wanL Lo meeL vlslLors
kLSCNSI8ILI1ILS
1% know Lhelr medlcal hlsLory
% omply wlLh LreaLmenL advlsed



% lnform docLor lf recelvlng LreaLmenL from anoLher docLor
4% know how Lhelr charges of LreaLmenL are besL covered
S% onducL ln a manner LhaL wlll noL lnLerfere wlLh oLher sLaff or paLlenL
6% keep appolnLmenLs
DCC1Ck A1ILN1 kLLA1ICNSnI
1he cenLral plllar ls LrusL and uncondlLloned poslLlve regard 8ond of relaLlonshlp can be
1% vert|ca| mode| docLor Lakes over conLrol and paLlenL have no roll vlrLually
% 1eacher student mode| docLor domlnaLes and guldes Lhe paLlenL and conLrols hlm
% Mutua| re|at|onsh|p hor|zonta| mode| docLor and paLlenL behave as parLners
8elaLlonshlp should be on empaLhy noL on love lL may noL be uneLhlcal buL may lead Lo un
professlonallsm
Ma[or Dangers
1% uocLor becomlng only savlor
% uocLor unable Lo swlLch off from paLlenL
% uocLor vlsuallzes hlm ln Lhe paLlenL
4% need Lo conLrol everyLhlng ln llfe of paLlenL
S% LnLhuslasLlc medlcal sLudenL glvlng or seeklng flnanclal or maLerlal help
6% uocLor becomes [udge menLal ln hls relaLlonshlp