::Dealing with relatives::

Dr Mahibur Rahman

This article was first published in Februray 2005 and is reproduced with the kind permission of Hospital Doctor, who retain the copyright.

Talking to the families of your patients can be one of the most difficult parts of your life as a doctor, but you can make it one of the most rewarding. It is part of everyday life for junior staff to be asked to discuss a patient's care. Although this may set off panic alarms inside your head, there are a few key things that can really help, whether you are breaking bad news or just updating the family on management plans.

Be prepared

You need to be fully aware of all aspects of the current situation before beginning a discussion with a family - incorrect information can produce problems later on. Arrange a time (even if it's only five minutes later), and go over the case notes to remind yourself of exactly what has happened, what is happening now and what is going to happen. If you are breaking the news of a patient's death, make sure you know as much about the events surrounding the death as possible (cause, time, people present etc.). Consult with other members of the team (especially nursing staff). If possible, ask someone to hold your pager while you deal with the relatives. Make sure you get permission (where appropriate) from the patient to discuss their care with relatives.

Set the scene

It is essential that any discussions take place in a suitable environment - ideally a quiet side room or office where you won't be disturbed. Holding a discussion around the bed is very rarely a good idea. There should be adequate seating for everyone. Standing when you are talking to someone can give the impression that you don't have much time, and need to rush off somewhere else. Try to bring a member of the ward staff with you - someone who can stay afterwards and explain or reinforce anything that you said.

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