Arguably one of the most difficult parts of being a nurse is delivering bad news to patients and their families.
Whether you’re informing a patient of an unfavorable diagnosis or telling someone their loved one has passed away, the situation is emotionally draining and one nurses dread.
To help make the task a little easier, here are a few tips for breaking bad news.
- DO ... Prepare for the conversation. Find a quiet, private room where there will be limited interruptions. Determine who should be present (for example, whether family members or friends should be included). Inform those involved they will be receiving serious information. Schedule adequate time to deliver the news and for the patient and family to ask questions.
- DO ... Be aware of your body language and tone of voice. Though you may feel nervous or distressed, it is your responsibility to remain composed and be supportive.
- DON’T … Assume you know what the patient or the family wants to hear. Some may want as much detail as possible while some prefer to learn just the basics. Ask open-ended questions such as:
- - What questions do you have about what I’ve told you?
- - Can you tell me more about what you are thinking or how you are feeling?
- - What other information do you feel you need at the moment?
- DO ... Be 100 percent honest and do not sugarcoat any part of the news. Providing inaccurate information not only gives the patient and family false hope, but it can also have legal consequences if the promised outcome is not the actual outcome.
- DON'T ... Use medical jargon. Assess the patient and family’s level of familiarity with clinical terms to ensure they fully comprehend what they’re being told.
- DO ... Deliver news one piece at a time and don't move onto the next until you're sure the patient and the family understand. Don’t accept silence as recognition or acceptance.
- DO … Repeat important information if necessary. The patient or family may not have fully processed what they heard the first time you said it.
- DO ... Actively listen and show empathy. Demonstrate that you recognize the gravity of the situation and let the patient and family express themselves however they prefer.
- DO ... Prepare for the stages of grief. Each person reacts to bad news in their own way. Your patient or their loved ones may quickly jump from denial to anger to bargaining in a matter of minutes, while other members of the family may remain in the first stage for days. Take this into consideration when addressing each individual.
- DO ... Allow the family time to digest the information before moving on to specifics about next steps or the treatment plan.
- DO ... Discuss the future. Let the patient and family know the immediate next steps and long-term plan for treatment. Offer resources and connect them with support services.
Delivering bad news will always be challenging, and, unfortunately, there will be times where you will be unable to thoroughly prepare. The best strategy is to practice with colleagues so you feel more comfortable when the situation arises. Remember that although you are in a difficult position, you have an opportunity to be a rock for your patient and his or her family when they are at their most vulnerable. How you support them can have a significant effect on their experience and possibly make this time in their lives just a little bit easier.
To provide the best experience for every patient during their hospital stay, nurses should adopt patient-centered care. Download the free eBook, How Nurses Can Increase Satisfaction through Patient-Centered Care, to learn more.