Telling a wife her husband has died unexpectedly
AMC Clinical practice station

The task

You are a junior doctor on a surgical ward. Mr Ivan Kovac, aged 64, had a knee replacement three days ago. At 06:10, while a nurse was helping him to the bathroom, he collapsed and lost consciousness at once. The team resuscitated him for 35 minutes, but he died. You were part of the team. The team suspects a large clot in the lungs (pulmonary embolism), but this is not confirmed. His wife, Helen, was called by the nurse and has just arrived. She has only been told that he has taken a turn for the worse, and has been shown to a quiet family room. Speak with Mrs Kovac. The examiner will not take part in the conversation.

What this station tests

• Use the word died; euphemisms confuse and delay grief.
• A warning shot, a pause and a short empathic statement are more helpful than a long explanation.
• Be honest about what is unknown; do not speculate about blame and do not promise what you cannot know.
• Explain coroner involvement in general terms and as routine for unexpected deaths.
• Offer to see the body, practical help, spiritual support and a named contact.

Sources for the clinical content

• Coroners Court of Victoria: Reportable deaths (example of a state coroner service)
• Coroners Court of Victoria: Information for families
• Grief Australia
• Medical Board of Australia: Good medical practice, a code of conduct for doctors in Australia

An original practice scenario with invented patients. Not an exam question.