Communication Matters October 25, 2023
Breaking bad news
The way to break bad news is so obvious that it is frequently skipped. Before you tell a pa-tient bad news; or before you tell a family about their loved ones death—consider doing the following:
1. Introduce yourself briefly to all in room.
2. Say the words “I have some bad news to share.” Make it personal: “Mrs. Wilson, I have bad news.” or “I have some bad news to share about David.”
3. Wait a few seconds to let that sink in.
4. Speak slower than normal and be direct (don’t tiptoe into it with softer words)
“There is a mass in your lung-it could be cancer”.
“David is dead.”
5. Wait even more time to let that sink in (it may take a while)
6. Now go back and briefly describe the events that led up to this bad news (including the things that EMS did/ or what the studies showed and the things you have done—if applicable)
7. Ask if there are any questions. And include children if present.
8. Now create a next step.
“You will be admitted to Dr. King. I assume they may discuss the
possibility of a biopsy.” or “ If you desire to see David’s body (it should not be assumed), I need to prepare you for what you will see. There is a tube coming out of his mouth….“We have to call the coroner’s office first and if that is OK, we will need to call a funeral home”.
9. Introduce your chaplain, and create a shared team.
10. Tell them how sad you and the staff are with this news. Express that now you will be there for them (friends and family) if you can help in any way.