Breaking Bad News

The process of breaking bad news to a patient may feel like a complicated one, and the idea of it daunting. But there are a few basic structure points to take into consideration to help one through it. In essence, it can sometimes turn into the unexpected but by the same token, you can expect the same thing to happen.


1.Preparation ( for you, for the disease or outcome of the patient concerned, what you know about it, what you want to say to them, what they need to know at the time, the room, the seating, the place and the day or time, the people around also listening.)

2. What does patient know? Could I ask you what you know so far about your condition, what have you been informed of /told so far?

3. Is more information wanted? ie, if they don't know, they need more information about what they need...this is to gauge their knowledge.

4. Give a warning shot... Mr.X I'm afraid to say its bad news, or I'm sorry to inform you that I have some bad news...or I'm sorry Mrs X, we tried everything we could, but he passed away, or I'm afraid I do not have good news to tell you...

5. Allow denial - if they deny, or cry - give them time for their grief - don't patronize them by saying anything during this time, silence is golden, especially where either rage or sorrow is concerned...eg in case of tears, saying anything more may encourage that emotion further, which may not be good if there is more to discuss with them. but don't rush them either.

6. Explain if requested - in layman's terms....explain results.condition.disease. whatever questions they have...ask if they have any qs.

7. Listen to their concerns - ask them how they are feeling if necesssary...

8. Encourage breathing -

9. Summary and plan

10. Offer availability (ie of ur service your bleep, nurse bleep, senior's contact bleep or whatever)


PART II:

Will I die doctor/do you mean I'm going to die doctor?
'It is true, that as your body gets weaker, it will not be able to sustain your life, and death will be the final outcome, as treatment is no longer sufficient to help you recover from this illness.'

~How long do I have doctor?
'I cannot really give you a specific known time frame, but based on what we know, that you are suffering with certain symptoms eg tiredness and sickness, in addition to what the results of the CT scan show, our best case scenario is between a couple of weeks and a couple of months, I very sorry to say - please note this is our best estimate'

'I'm sorry to have to tell you that the results are not good. ....'