GP Stage 3 Simulated Consultation - Relative 3
You are an SHO on a Care of the Elderly Ward. Charlie Smith, the child of Mr Smith would like to meet with you. Mr Smith was a patient on your ward for over 6 weeks and had made a good recovery from a Lower Respiratory Tract Infection (LRTI) until he suddenly passed away from a Pulmonary Emboli (PE) last week. You were told by your consultant yesterday that there is an internal investigation into this, given that Clexane was accidentally omitted when Mr Smith’s drug chart was re-written 72 hours prior to his death.
You have no reason to believe that Mr Smith would not have wanted his relatives to be kept informed about his health, and have previously met his relatives during Mr Smith’s inpatient stay.
You are Charlie Smith, the child of Mr Smith and have come to meet the ward doctor who looked after your father leading up to his death last week. You would like to thank the doctor for looking after your father so well, reporting that Mr Smith was very fond of this doctor in particular.
Given that the care on the ward was so good, you would like to make a donation to the ward and would like details on how to do so. On a separate note, you are intrigued regarding how your father’s health deteriorated so suddenly, despite his initial promising progress and would like to know if it is common for ‘patients with pneumonia’ to initially improve and then suddenly decline.
You are not aware of any other contributing factors to your father’s death, and if suggested that there were other factors, you become very angry suggesting that there has been a ‘cover-up’ and demand to see the consultant in charge as well as a full inquiry.
At home, you presently live on your own after living and caring for your father, for the last 10 years (since the death of your mother). You are feeling increasingly lonely with a low mood and poor appetite. You are concerned that you are becoming increasingly depressed and have not had formal employment for over 10 years.
This is a challenging consultation made harder by the asymmetric information. Whilst it is not wrong to inform or suggest that additional factors may have contributed to Mr Smith’s death, better candidates are likely to arrange a further meeting in the presence of senior colleagues, in order to discuss this sensitive matter further, rather than breaking this news with limited information. Ignoring the matter completely or lying about the cause of Mr Smith’s death would be seen as wholly unacceptable.
On a separate note, whilst encouraging patients/relatives to make donations is unacceptable, providing them with the necessary information (after receiving a request) is appropriate and supportive.
Additionally, whilst emotional support is essential, providing medical advice would not be appropriate, with good candidates advising Mr Smith’s child arrange to see their GP regarding their low mood.