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Nurses play a vital role in delivering bad news to patients.
Bad news has been described as any information that can negatively impact how an individual views their future. In your nursing career, you will encounter the common occurrence of breaking bad news to patients and their families.
This is easier said than done right? For example, a study found that 50% of parents were not satisfied with the way they were told about their child’s congenital deafness.
There are several factors that may affect a nurse’s ability to deliver bad news sensitively, including burnout and fatigue, personal difficulties, behavioural beliefs, and subjective attitudes, such as fear of death.
MedGen have put together some advice that nurses may find useful when dealing with bad news.
Preparation
Although this step may seem obvious, most nurses deal with several patients during their long hour shifts which makes this step essential.
Before breaking bad news to a patient, make sure you are 100% familiar with the facts of the case and the information that surrounds it.
Communication
Patient-centred communication is a contributing factor for high-quality patient care. This form of communication requires a great deal of professionalism, patience and energy.
Nurses should ask open-ended questions to determine what the patient is expecting and the knowledge they currently have on their situation.
Communication with various members of staff across a shift could sometimes cause confusion.
This will help you tailor the way you deliver the information and where you begin.
Deliverance
In a hospital setting, it can often be hard to find a private area, however, delivering bad news in private will give the patient/their family a comfortable space to express their emotions.
The first step in delivering the news is to “Fire a Warning Shot” and warn the patient and family that the incoming news is not good. For example, by saying “Things are not going in the direction we had hoped,” allows the patient and family to emotionally brace themselves for the information to follow.
It is best to provide small amounts of new data at a time to allow the patient time to process all of the information appropriately.
Empathy
When delivering bad news, patients will have a wide range of emotional reactions as they respond. This may range from silence to crying and sobbing.
To avoid any awkwardness between the Nurse and the patient, an appropriate and kind response to the emotion demonstrated when the patient hears bad news is critically important. This will largely consist of demonstrating empathy and understanding to the patient.
Strategy for the future
Going back to the preparation step, revising tips that could help the patient/family moving forward is important regardless of how ‘bad’ the news is.
For example, if there is no further treatment that can be done, mental health resources that can help patients to cope with the news can be offered.
Alternatively, a clear discussion of the treatment programme should take place considering the patient is ready to discuss this.
Things to avoid
· Do not assume all patients will have the same response to a scenario as everyone is different
· Avoid rushing the conversation as it is important to give the patient enough time to express their emotions- this may be difficult when
the Hospital is busy
· Avoid impairing the patient's comprehension- For example, ensure you don’t give the patient ‘false hope’ when trying to be optimistic
In conclusion, breaking bad news has always been a difficult task as I’m sure you will already know. Hopefully this guide helps you in your nursing career.
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