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Learn more on our RCA course. https://www.pennine-gp-training.co.uk.... Two common BBN situations requiring different approaches to the consultation. Have a look at our CSA cases and practice BBN in your CSA groups https://www.pennine-gp-training.co.uk... Not expecting bad news or little anxiety around a result Welcome the patient Start with the usual open question Find out why the test was organised What was said at the time of the test What has happened since Find out about them as a person The warning shot PAUSE – do not talk until after they do Succinctly deliver the bad news PAUSE – do not talk until after they do Allow time for emotion Show empathy Allow time for the bad news ‘to sink in’ Answer any questions they may have, as best you can Explore SPICE and what happens next Agree what you and the patient may need to do before review Arrange review (soon) Summarise before they go Very anxious about a result Welcome Cue led approach to the opening statement Patient anxiety around an anticipated result can paralyse the consultation – there will be verbal and non-verbal cues You need a different approach You cannot draw out the consultation asking all the background questions Explain "I can see you are very anxious about the result. Normally I would find out about what lead up to the test and what happened next and find out about you. But I can see you are really worried. Let me give you the result and we can sort that out afterwards." The warning shot PAUSE – do not talk until after they do Succinctly deliver the bad news PAUSE – do not talk until after they do Allow time for emotion Show empathy Ask any background questions (SPICE) Agree what you and the patient may need to do before review Arrange review (soon) Summarise before they go Category Education