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Breaking Bad: How to Best Support Patients Who Get Difficult News

Wednesday, July 12, 2017 9:00 AM

Expert Advice

Written by: Laura Baldwin

Laura Baldwin
Senior consultant

Delivering difficult or bad news to patients can be a sensitive and uncomfortable challenge for health care providers. Keep in mind that even the smallest bit of unpleasant news can create stress and anxiety in patients. In most instances, the physician is responsible for leading this dialogue. However, it is important that staff be adequately prepared to provide support, ensuring that patients know they are surrounded by a compassionate, understanding team.

To appropriately handle a “bad news” patient scenario in an effective and positive manner, practice staff should:

Demonstrate empathy. While many employees may have never personally received bad news, they must put themselves in the patient’s position and consider their own reactions. To better do this, staff members might consider asking themselves these questions: How would I feel if I were told that my vision loss is irreparable? How would I react if someone told me that I will continue to have vision loss until I am blind? How might I feel if I were on the receiving end of news that will impact my quality of life and independence? A staff member’s own feelings are some of the most important tools one can utilize when interacting with patients who receive bad news.

Address patient emotions. When faced with bad news, patients will react in a variety of ways — silence, anger, denial, sadness. Staff members should attempt to assess emotive reactions so the appropriate response is provided. Verbal clues would be ideal, but it may be unlikely that a patient comes right out and says, “I’m sad” or “I’m angry.” More often, staff will need to look for nonverbal clues such as tears, a look of sadness, clenched fists that may indicate anger, or other indicators that allow insight into the patient’s emotions.

Be available. Once a patient has received bad news, the ability to absorb and process any additional information is limited. However, the patient may feel inclined to stay and speak with someone immediately following the visit. If that’s the case, do not try and rush the patient out the door. Allow him or her to spend the time necessary to express feelings or concerns. Listen well, acknowledge feelings, and respond empathetically.

Allow for hope. English author Samuel Johnson once said, “Hope is necessary in every condition.” Most people continue to hope even in the most difficult situations, and it is important that all staff members allow for that hope to exist no matter what the odds may be for a favorable outcome. Hope is individual and very personal, and no one has the right to tell another person that they should not hope. That being said, there is a fine line between allowing for hope and instilling a sense of false hope. As a caregiver, it is important to continue to gently reinforce the appropriate message related to a patient’s condition so that accurate expectations are set.

Delivering bad news is never a pleasant experience. It is difficult for the patient, the physician, and the staff. The ability of staff to offer support and comfort to patients when difficult news has been delivered is a critical and important part of the patient experience, and, if done appropriately, can have a positive impact on everyone.

YOUR TURN: What other tips do you have for staff to support patients who have just received bad news? Please leave your response in the comment section below. Thank you.

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