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Demonstrates to others good practice in ‘breaking’ bad news Involve patients and carers (where relevant) in decisions regarding their future management comprehends the impact of the bad news on the patient, carer (where relevant), supporters, staff members and self Aware of the steps to take in preparing to break bad news:  Set aside sufficient uninterrupted time  Choose an appropriate private environment and ensure that there will be no unplanned disturbances  Have sufficient information regarding prognosis and treatment  Ensure the individual has appropriate support if desired  Structure the interview  Be honest, factual, realistic and empathic  Be aware of relevant guidance documents Awareness of how to structure and conduct the interview:  Set the scene  Establish understanding  Discuss; diagnosis(es), implications, treatment, prognosis and subsequent care  Encourage questions and ensure comprehension  Respond to verbal and visual cues from patients and carers and relatives (where relevant)  Act with empathy, honesty and sensitivity avoiding undue optimism or pessimism

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