Approaching a Patient with Bad News

Healthcare Training Resource
August 7, 2013 — 1,189 views  
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Doctors and nurses perform not only the job of care and treatment but they also have the responsibility to communicate bad news to their patients. This task may seem simple on the face of it, but is a task that comes with a huge responsibility. There is no clear and universally applicable protocol on this form of communication. Though the doctors have not been trained to perform this task, an understanding on how bad news should be disclosed has begun to emerge.

Planning the Disclosure

Sufficient planning should go into the act of disclosing unfavorable news to a patient. It must be considered a part of the medical procedure that requires stepwise execution of a plan. In medical procedure, the completion of each task ensures the success of the next. In disclosing bad news to a patient likewise, the steps to plans must be executed with great care. In other words, what is to be said to the patient, how it is to be said, where and when they need to be informed are all parts of the plan that must be carefully anticipated and executed.    

The first step to the plan is information gathering from the patient so that the physician can make a judgment on the patient’s ability to understand and bear the bad news. Next, the physician must offer intelligent information unique to the patient’s desires and needs. The third goal is to employ skills to reduce isolation and emotional impact experienced by the patient. Finally, the physician should engage the patient in the treatment plan beginning with discussion with and cooperation from the patient. As the physician follows the four stages of planning successfully, the patient will feel much more relieved and better than when they first heard the news.

Breaking the News

There is an appropriate way of breaking bad news to the patient. The physician should speak to them in a language that is plain, simple and clear to understand for the patient. The interview should move free of technical jargons and slow enough for the patient to understand and clarify if they want to do anything at any stage. A common complaint in this context has been that the medical staff spoke to them in a language that they could not understand.

When patients are given a warning shot like “I am afraid, there is bad news” it helps them face the reality after the statement sinks in. The physician should make an effort to understand what the patient already knows and expects. If educated patients want to get into the depth of the news, it is recommended that the physician should answer their queries in as much depth and detail as they want.

People fear the terminal stage the most. If the physician thinks it may be too much for the patient to tell them all at once, it is not necessary for physicians to cover all aspects. When ambiguity is needed or appreciated by the patent, in case the prognosis is poor, the physician should respect the patient’s desire.  

A huge responsibility devolves on a physician, who wants to break bad medical news to a patient. It requires a considerable skill and training to handle such assignments with an appropriate degree of empathy with the patient. The physician must appear to be loving and caring while breaking the bad news.   

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