“The relative of patient xx want an update”

Updating the next of kin & relatives is one of the more common tasks you will be expected to do on the ward when your consultant and registrar have gone to the clinic and you’re the only member of the team left on the ward. Please note there are specific articles on dealing with complaints, breaking bad news or discussing DNAR.

Practical tips:
  • Do not be intimidated! As the FY1, you know your patient best in terms of what is going on, what investigations are being awaited, therapist input and discharge plans
  • Ensure the patient is happy for you to speak to their relative(s). Always ask if they would like to be present during the update.
  • If you don’t know something, just be honest and offer to find out, or ask a senior and arrange a phone call/in-person meeting
  • Be honest at the start about your role i.e. team doctor or on-call. If you are on call avoid updating about non-emergency plans unless you have to (because the relatives are distressed or angry). You can inadvertently provide incorrect information in the limited time you have.
  • Find an appropriate place i.e. by the bedside for a brief update of progress, a quiet room if you’re breaking bad news
  • Keep it simple and avoid jargon (or at least explain it if you do)
  • After your conversation clearly document in the patient’s notes for future reference
Communication tips
  • Start by ascertaining how much the other person already knows, this will make it easier for you to reference in the course of the conversation
  • Break up topics into small chunks and ensure the other person understands
  • Invite questions rather than just give lots of information, this keeps the conversation centred on the other person’s concerns
  • If you are on-call and only have a few moments, make this clear at the start or if possible ask a colleague to hold the bleep
  • Offer to have another colleague present if you pre-empt a difficult situation, i.e. an angry/upset relative
  • Clearly document what you and the other person have said in the notes when finished, if there are any concerns or unresolved issues inform your seniors and/or other members of the MDT as needed. This is particularly relevant if you are not the main team doctor, e.g. on-call.
  • If you need to speak to relatives over the phone, e.g. in an emergency situation, be mindful to keep to a minimum, particularly if you have not met in person and advise them to come in person where you can provide more information.
Written by Paula Busuulwa (FY3)