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Feb 2, 2012 · Breaking bad news is an important clinical skill that can be frequently utilized in the context of routine practice. Following an established protocol while integrating empathetic communication makes the difficult task of breaking bad news more comfortable for the NP and helps improve the communication between the patient and family.
- Margaret Quinn Rosenzweig
- 2012
- Overview
- Selecting Your Words
- Choosing the Right Context
- Delivering Bad News Effectively
Breaking bad news to someone is never a pleasant task. But, breaking it at the wrong time or in the wrong way can be even worse. It's important to know the best approaches to breaking bad news. The real difficulty (besides the content of the bad news) is that it is just as hard for the person breaking the bad news as it is for the person receiving ...
Work through your own reaction.
Before preparing yourself to tell someone else, take care of yourself.
The news may impact you, too. Or, it may disturb you considerably even if it doesn't impact you directly. It is important for you to have given yourself a chance to recover your
before you try to explain things to someone else.
, take a shower, meditate or do deep breathing for a few minutes, or simply sit in a quiet dark place for some moments to give yourself the chance to pull together. Once you've moved past the initial
, it'll be less intimidating to tell the other person but it's important to acknowledge that it may still be hard.
Determine if you're the right person to break the news.
If you're a casual acquaintance who has just happened to learn early about some breaking bad news, possibly you should not be the bearer of that news. But if you are the sister of a woman who has been rushed to hospital, then you are probably the right person to break the news to the rest of the family.
It's insensitive to blast personal or sensitive information all over social media, for example, just because you know something. If the news relates to a death or other serious circumstance, give the family and close friends time to call or visit people personally before you jump in and get involved.
Ensure that the physical setting is
The worst thing that you can do is to blurt something out in a public space with nowhere for the recipient to turn or even sit down to cope with the aftermath of hearing it. Choose an area that has somewhere to sit or rest.
Also, consider taking the person to a location that has a low likelihood of being intruded upon by other people. Other things to do to improve the environment include:
Signal the bad news before you dive in.
A transitional statement can help the person get ready for unexpected bad news. Although you want to get to the point right away instead of beating around the bush, you do want to at least prepare the person for the prospect of upsetting news.
You can use phrases such as: "I have some sad news to tell you", "I've just received a call from the hospital: there has been an accident and..."; or "I've been talking to your specialist and...", "There is no easy way to say this but..." or "There's some really bad news you need to know..." etc.
Offer comfort to the person, if appropriate.
As you narrate the events, react to the
of the other person as they arise by acknowledging and addressing them.
- 29 sec
- 561.3K
- Tasha Rube, LMSW
- Setting. It’s important to break bad news in an appropriate setting: The discussion should occur in a comfortable, quiet and private room. Although this is not always possible, make sure you have at least some privacy and that the patient and family have somewhere to sit.
- Perception. Begin by discussing the sequence of events leading up to this point (e.g. scans, biopsies, etc) and assess the patient’s current emotional state.
- Invitation. Check if the patient wants to receive their results today – in an OSCE setting the answer will always be yes, however, on the wards, be aware that some patients may recognise the news may not be what they hoped for and may want to put it off until family are present: “I have the result here today, would you like me to explain it to you now?”.
- Knowledge. Ensure you deliver the information in sizeable chunks, and regularly check the patient’s understanding. Use a warning shot to indicate that you have unfortunate news: “As you know we took a biopsy/did a scan, and unfortunately the results were not as we hoped”.
Aug 1, 2000 · Breaking bad news to cancer patients is inherently aversive, described as “hitting the patient over the head” or “dropping a bomb” [ 6 ]. Breaking bad news can be particularly stressful when the clinician is inexperienced, the patient is young, or there are limited prospects for successful treatment [ 3 ].
- Walter F. Baile, Robert Buckman, Renato Lenzi, Gary Glober, Estela A. Beale, Andrzej P. Kudelka
- 1806
- 2000
- 01 August 2000
May 22, 2020 · Steps for Breaking Bad News to a Loved One. Breaking Bad News Examples. Frequently Asked Questions: Breaking Bad News. Reassuring someone who’s just heard devastating news can be difficult, especially if you’re the one who told them.
Mar 15, 2021 · Learn how to deliver tough medical news to patients using the SPIKES and BREAKS protocols, which are methods for enhancing communication and creating better patient outcomes. Compare the six steps of each protocol and see examples of how to apply them in different situations.
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Jan 13, 2022 · Learn how to use the SPIKES protocol, a communication tool for breaking bad news to patients with cancer. The guide covers six phases of the process: setting, perception, invitation, knowledge, empathy, and summarize or strategize.
