Setting

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• WIPER

• Ask if they are happy to see you

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Perception

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• Recap on past events – symptoms, investigations so far

• “Thank you for bringing me up to speed.”

 

Invitation 

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• “Results are back, can I give them to you now”

Knowledge

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• Unfortunately it is not the news we were hoping for.

• The scan shows that you have a benign tumour called an acoustic neuroma. PAUSE

• Would you like me to explain the condition

  • It is a non-cancerous tumour/growth of the brain. This means it does not spread

  • In particular it grows on the nerve used for hearing and balance, which can cause problems such as hearing loss and unsteadiness.

  • This is why you are getting the symptoms you have been describing

• Treatment options

  • Conservative –these are slow growing so we can keep you monitored with annual scans to see if it is getting better

  • For hearing – use hearing aids

  • Tinnitus – mainly distraction techniques

  • Surgery – remove tumour – risks associated with this including losing hearing

  • Radiotherapy

• Refer to skull base surgeon and discuss at MDT to see which is best option

• Even with treatment, symptoms such as hearing loss and tinnitus can persist and affect your ability to work, communicate and/or drive. These problems may need additional treatment

Empathy

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• I am sorry, I know this is not the news you were expecting

Strategy and summary

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• Summarise findings

• Offer leaflet

• Answer any questions

• Offer hearing aid in mean time for safety 

Round up and safety net

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• If dizzy need to stop driving as per DVLA (DVLA guidelines for acoustic neuroma)

• Today we have talked about…. – Do you have any further questions?

• Once again my name is…

• Give secretary's number