Communicating
with
Confidence
Authored by Sally Phillips and Jane Hamilton
Communicating
with
Confidence
Authored by Sally Phillips & Jane Hamilton
Aims of the Session
Delegates should leave feeling confident to:
1. Manage challenging conversations
2. Take away a tangible “toolbox” of
communication skills
3. Acknowledge and understand own fears
and how to overcome them
4. Share information with and support other
team members
5. Recognise your own limitations and that
within your work role
COMMUNICATE
What do you understand by this word?
CONFIDENCE
What is your perception of confidence?
Group work/role play
Each group will be given 2 different scenarios to
discuss:
•What are your immediate feelings about these
situations?
•What are the main areas you need to consider?
•How will you handle this?
•What types of communication might you use in each
case?
Group work/role play
• Look at each scenario
• Discuss each scenario as group
• In the group, practise playing out each
scenario
• Each person should take it in turns to
be “patient”, “relative” or “care worker”
• Decide which scenario to present to
main group.
Presentation to Main Group
Each sub group will decide:
•
•
•
•
Which scenario to present
Who will record group’s ideas
Who will present these to whole group
Who will role play chosen scenario to
main group
Scenario 1
Mr Harris, attending day care, is unusually
rude to the driver, ignores the receptionist on
his way in and throws the cushion out of the
chair before he sits down. Everyone nearby is
alarmed at his behaviour. As you approach
him he says:
“And you can “**** off too”
How would you handle this?
Scenario 2
Mrs Khan was successfully treated for ovarian
cancer several years ago. She has recently
become unwell and is undergoing
investigations for abdominal pain and vaginal
discharge. Mrs Khan only speaks a little
English. Her husband died last year.
Through her teenage grandson, her main
interpreter, she asks what is happening?.
How would you deal with this situation?
Scenario 3
Tim is aged 42yrs but has a learning age of
9yrs. He has been unwell for the past 12
months and has been diagnosed with prostate
cancer with spread to his bones. He lives with
his elderly parents who are both becoming
very frail. He experiences significant mood
changes with aggressive behaviour due to
hormonal treatment and is now needing
radiotherapy to control bone pain.
How would you explain the changes happening
to him and the treatment needed?
Scenario 4
You have been visiting Mrs Smith at home for
several weeks, keeping her company whilst
her daughter, with whom she lives, goes
shopping. Mrs Smith has become gradually
more frail both physically and mentally. On
this occasion, she seems quite agitated
and tells you “that woman has been horrible to
me. She shouts at me, hasn’t given me
anything to eat and won’t let me have a bath.”
How do you respond?
Scenario 5
You have been asked to work with Anne,
recently diagnosed with breast cancer and now
in the middle of treatment. She has Downs
Syndrome and lives in a home with other
adults with learning difficulties. Her carers are
worried that Anne does not seem upset by her
diagnosis and may not understand its possible
implications.
You are asked to find out what she does know.
Scenario 6
You visit a young woman at her home.
Sarah has advanced cancer and knows
that this is going to be her last Christmas.
She asks you to help her wrap presents
for her children and to write out cards for
all her family and friends.
How do you respond?
Scenario 7
Mark, who is currently in hospital with
end stage liver disease, wants to go to
the football match with his partner, Chris
who is happy to take him. His mother
and sisters are adamant that this will not
do him any good and insist he stays put.
You are in charge of his care in hospital.
What do you say to Mark?
Scenario 8
You go to see Mr Kear at home. He is single with
no immediate family and few friends. He has a
history of schizophrenia. He was told 13 months
ago that he only had 12 months to live. He gave
up his job, sold most of his possessions to raise
money and has spent time travelling. Medically
he has remained unchanged. Yesterday Mr Kear
was told he had been mis-diagnosed and that he
is not dying.
You have been asked to discuss this new
situation with him.
Scenario 9
It’s late on a Friday afternoon and most staff
have left the building. Reception has put
this call through to you as an enquiry about
referring a new patient.
Paul, a 50 year old gentleman is ringing to
enquire about referring his wife to your
service. He explains that his 45yr old wife
has recently been diagnosed with cancer
and is having difficulty coming to terms with
the news. He has heard from a friend that
the hospice may be able to help. He stops
and there is silence ………he starts to cry.
Scenario 10
A patient, Molly rings you on reception at 9.30am.
She is cancelling her appointment that was due at
11am today.
She starts to cry and explain that she received bad
news from her Consultant yesterday - has learned
that her cancer has spread.
‘I really can’t face meeting anyone at the moment –
I am sorry to cry. I didn’t mean to………’
She sobs and says sorry again.
What do you say?
Scenario 11
Mary, a patient whom you have known for a
while has phoned to cancel future transport
and appointments.
She explains without emotion that she knows
she doesn’t have long to live and that she
wants you to pass on her thanks to all the staff
who have helped over the last few months.
What do you say?
Scenario 12
You are assisting Miss Robinson, a 58 year old
lady, to have a bath. She is a retired headmistress
and now a lay preacher in her church and is living
with MND (motor neurone disease). You have been
working with her for many months and have seen
her condition decline markedly over the last 6
weeks. She says to you:
“I have had enough – I can’t go on living like this,
it’s only going to get worse and it’s not fair on my
family and friends. I have decided to go to
Switzerland to end it all. I know you are the only
one who understands how I feel. Please will you
come with me?”
Scenario 13
Mrs Paterson has returned to her care home
following a short stay in hospital where tests
showed that her tumour has enlarged and spread.
Further treatment is not likely to help and could
make her feel very unwell. She has accepted her
prognosis and has told staff at the home that she
wants to die there, “just quietly and peacefully”.
She knows her daughter will be upset, will want her
to try every treatment and will not want her to “give
in”.
Mrs Paterson has asked you to be with her when
she tells her daughter the news.
Scenario 14
Mr McClean, a single gentleman, has been a
resident at your care home for several years.
He has made a lot of friends and is very
popular. His Parkinson’s disease has now
progressed and he is becoming more and
more confused and gets very agitated at times.
He tells you he doesn’t like all these strangers
coming into his room at night. His niece is
visiting from Scotland. He has asked her to
“take me home”.
She asks you what you think she should do.
Scenario 15
You are visiting Mr and Mrs Wilson at their home.
You see Mr Wilson sitting in the garden – he tells
you that he has been diagnosed with widespread
cancer and has only a short time to live. He wants
you to help him make some arrangements whilst
he can. He then says that his wife and family think
he is just a “bit anaemic” and will get better with
the new tablets.
“I don’t want them all to get upset. I’ll tell them
when I’m ready and I don’t want anyone else telling
them either.”
Scenario 16
You have worked over your hours on your shift
and are now about to go off duty. You have an
important personal appointment to attend and you
are running late.
As you get to the door, Susan (a client) stops you
and says:
“I saw the consultant today and its bad news. I
really need to speak to someone – have you got
time?” She is looking very anxious.
How do you respond?
Scenario 17
John was given his diagnosis some 6
weeks ago but does not appear to have
accepted it. He does not talk about the
future. He has become very “happy go
lucky” and seems unperturbed. Yet, from
time to time, he looks sad and a bit red
eyed.
What would you say to John?
Scenario 18
You work on a busy, acute medical ward. Mrs
Holmes, a 46 year old single parent of 2 teenage
sons, is admitted with a chest infection. She does
not respond to antibiotics and tests reveal she has
advanced lung condition which is not treatable.
Her prognosis is short.
She does not want her sons to be told – “it will be
too upsetting for them”. Her elderly mother, who
lives nearby, is visiting and says to you: “my
daughter is very poorly, isn’t she? What is wrong
with her?”
How do you respond?
Scenario 19
You work in the community. You are visiting a
young man who has an inoperable brain tumour
and whose condition is deteriorating rapidly.
He has just been discharged from hospital and
returned to live with and be cared for by his
parents. They all know he is dying. They think a
nurse will be with them 24/7 and have asked you
to confirm the arrangements. You know that this
is not possible and that the care package is for a
carer to come for 45 mins, 4 times a day.
What will you say?
Scenario 20
You meet Mr Ramsay in your workplace.
This gentleman, although physically fit
and well, looks very tearful and sad.
When you ask him what is the matter,
you realise he is unable to speak- his
tongue has been removed.
What do you say and do?