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The first time: breaking bad news

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Breaking bad news can be a terrifying prospect but there are steps you can take to ensure the process is as comfortable and supportive as possible

Whether the news is relative’s death or informing a patient they have a terminal illness, the process can be harmful if not carried out with care. There are several steps to take to be sure that breaking the news is as comfortable and supportive as possible.  

Talking about death

Delivering news of a patient’s death can be among the most challenging experiences as a nurse.  In this situation it is important to communicate what has happened in a clear and honest way to the patient’s relatives.

  • When possible, try to break the news of a death face-to-face rather than over the phone.
  • If the death occurs when the relatives are not present you will need to telephone to ask them to attend the hospital. If the relatives enquire if the patient has died they need to be told the truth
  • Find a private area with room to sit down where you won’t be disrupted.  Be sure the location is somewhere that can be used for an extended period of time; tell other staff what is happening so they know not to disturb you
  • Sit and maintain eye contact. 
  • Be straightforward. Use words such as “dead” and “died” while avoiding euphemisms such as “passed away”
  • Communicate in a sensitive tone of voice 
  • Give relatives time to ask questions
  • Think about how much the relatives already know, and how much they may want to know
  • Advise the relatives on practical matters that need to be taken care of
  • Allow the relatives as much time as they need to process the information.

Talking about a serious illness

Breaking the news of a serious illness can be just as overwhelming as news of a death.  When talking to a patient about their serious illness, remember to be just as straightforward and honest as you would in any other situation.  Be sympathetic to the patient’s needs.  Use all of the tactics that you would for breaking news of death, and be straightforward in discussing the options for treatment. Do NOT, under any circumstances, exaggerate your optimism for the patient’s future. While you want to be sympathetic, your job as a nurse is to give the facts and be a support system. Giving any sort of false hope could compromise both your trust and the patient’s ability to make rational decisions regarding his or her future.

As a whole, remember that however challenging this is for you, the process is about making it as painless as possible for the patient and relatives.  It is easy to feel guilty or uneasy with a reaction to grave news, but always keep in mind that you have no reason to feel guilty; you are not responsible for any of the news you deliver. It is, however, your responsibility to support the patient or relative through their journey to emotional recovery.

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Readers' comments (1)

  • Adam Roxby

    This is a brilliant article. Starting to think about these issues now will get students ready for the time that they become nurses.

    This is why it is my Editor's pick.

    Unsuitable or offensive? Report this comment

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