Microsoft powerpoint - tsai-2012-badnewsdelivery20120315-ppt

news that drastically and negatively changes a recipient’s view of their future (Buckman 1984:1597) • Common but challenging• Bringing up a difficult topic • Emotional distress on the news recipient Third Conference of the Asia-Pacific LSP and Professional Communication Association: Crossing Boundaries: Working and Communicating in the Asia • My first time giving bad news was inadvertent and • My intern sent me out to speak to the mother of the child harrowing. I was a third-year medical student on rotation and ask her permission to do an autopsy. Without thinking in a busy inner city ER. A family (grandmother, 10-year- I began with, "Sorry to bother you at this time but." old girl and her uncle) came in badly burned in a house After I asked the mother my question, which made it clear fire. The girl was in arrest. The grandmother was alive but that her daughter was dead without my preparing her or critically burned. It was the most overwhelming thing I stating it, she screamed. She then collapsed, hysterical, at had ever experienced. Another student and I were my feet. I was aghast, guilty, stunned and felt inadequate responsible for debriding the girl's third-degree burns. The to provide any appropriate response. I still feel awful smell of charred flesh was overpowering and all efforts at when remembering this some 25 years later. • (Frankel, Richard M. 2001. Challenges and Opportunities in Delivering Bad News. Managing Risk 7.1-4.) • The conversational mechanisms via which --Get the physical context right --Where?-- Who should be there? --Starting off • To facilitate the news deliverer’s task 3. Find out how much the patient wants to know4. Share the information (Aligning and Educating)5. Respond to the patient's feelings6. Plan and follow-through • Methodological difficulties in carrying out • How does the discourse analysis of bad – access to collect conversational data of such dialogues, facilitate our understanding of • Patient proxies, e.g., simulated patients, – Instead of announce the bad news directly, the news deliverer tend to give off some verbal or non-verbal clues which then lead the recipient to guess what the coming news • Discourse analysis of three scenes of bad • Guiding the recipient’s incorrect guesses • Rejecting the incorrect guess with a • As an essential mechanism in delivering a bad • Non-vocal forms of forecasting lead to the spontaneous and non- spontaneous discourse.
• This mechanism is generated by the deliverer’s sense of empathy which creates an atmosphere of un-usuality and leads the receiver to guess • The lack of the presence of empathy and sense of un-usuality fails to orient or prepare the 1. T: (In Dr. Slamon’s consultation room, Tina got some 9. S: I'm sorry, Tina. (Pause for 2 seconds) You herbal leaves from her bag and offer them to Dr. Slamon) Fresh from my garden. Echinacea, for 11. T: Not moving on? …But you said last week I was  12. S: … And you are. (Pause for 2 seconds) But for 4. T: I know I'm here for my official results, but I the study, . for its ultimate success, I've been already know… Dr. Slamon, I feel so much given a set of standards by the FDA. (Pause for 2 seconds) I need to narrow the group down to the ones who are having the most 13. T: That's me. I've gained weight, and I'm not in Hello. Sorry to keep you waiting. Busy day.
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• My intern sent me out to speak to the mother of the child and ask her permission to do an autopsy. Without thinking I began with, "Sorry to bother you at this time but." After I asked the mother my question, which made it clear that her daughter was dead without my preparing her or stating it, she screamed. She then collapsed, hysterical, at my feet. I was aghast, guilty, stunned and felt inadequate to provide any appropriate response. I still feel awful when remembering this some 25 years later.
• (Frankel, Richard M. 2001. Challenges and Opportunities in Delivering Bad News. Managing Risk 7.1-4.) In contrast, no such an sense of unusuality creates an atmosphere of un-usuality and leads the receiver to ‘guess’ or ‘announce’ recipients for the coming of a bad news. This lack of unusuality can be either the • The lack of the presence of such a sense of unusuality fail to orient or prepare the

Source: http://lc.flld.ncku.edu.tw/publications../Tsai-2012-BuildingUpAnAtmosphereOfUnUsuality-ppt.pdf