Preparing to break bad news

Preparing yourself:

  • Be aware that delivering bad news is stressful. If you have had a stressful day, check in with your colleagues who are supportive and discuss the issue with them.
  • Ensure that you have adequate time to spend with the patient.
  • Be aware that you may experience strong emotional responses (fear, anger, sadness) yourself.
  • Recheck all the facts; review the reports; talk to the involved experts ( oncology, pathology etc) and get your facts straight
  • Identify items on your agenda:
    • What are you planning to tell the patient?
    • What are you hoping to accomplish by the end of the meeting?

Preparing the patient:

  • Determine who should be present at the meeting.
  • Be aware that some patients live alone and have no family and friends. These patients are especially vulnerable to the stressful after effects of receiving bad news.
  • Be aware that some patients may lack capacity to understand the medical information and make decisions.
  • Patients from different cultural background may not speak or understand English. In such cases, please ensure that you have a trained professional interpreter available. It is not a good practice to have family members serve as interpreters.

Preparing the setting:

  • Find a private and quiet place for the meeting.
  • Make sure that everyone has a place to sit as feasible.
  • Turn pagers to a vibration mode during the meeting.
  • Have paper napkins/tissue available ( as patients may get very tearful)
  • Make sure that the participants introduce themselves.

 

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