The Difficult Conversation Preparer

Help me prepare for a difficult conversation with a patient or
family.

The conversation: [BREAKING BAD NEWS / GOALS OF CARE / TREATMENT
FAILURE / DECLINING A REQUEST / DISCLOSING AN ERROR / ESCALATION
OF CARE]
Setting: [WHERE, HOW MUCH TIME, WHO IS PRESENT]
What I know about how they will react: [DESCRIBE]
What I need to achieve: [DESCRIBE]

Produce:
1. An opening — the first two sentences, verbatim
2. A warning shot, if the news is bad
3. The core information in plain language, in the smallest number of
   sentences that is honest
4. Three likely responses and how to handle each
5. Phrases to avoid, and why they land badly
6. How to handle silence
7. How to handle a direct question I cannot answer
8. How to close and what to arrange before they leave
9. What to document afterwards

Use a recognised framework ([SPIKES / NURSE / ASK-TELL-ASK]) and
name it.

Write the actual words, not descriptions of what to say.