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End of Life Online Curriculum - Modules
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Communication: Breaking Bad News
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Conclusion
- Clinicians often have to deliver bad news to patients.
- Both delivering and receiving bad news are intrinsically stressful events.
- Preparing in advance, carefully setting the stage and crafting an agenda and following the steps described below are helpful.
- Typical steps often used in delivery of bad news:
- Warning shot : Tell them that you have some unpleasant news for them
- Pause : Wait for them to take a deep breath and get ready to hear the bad news.
- Deliver bad news:
- Use short simple sentences.
- Avoid common communication errors studied earlier
- Be sensitive and compassionate
- Empathic silence: Wait for them to intake and process the bad news.
- Answer questions : The bad news will prompt a lot of questions. Answer them patiently
- Assure nonabandonment: Inform the patient that you will be coaching them through the next steps
- Make follow-up plans: Clearly elucidate the next steps
- Debrief and self reflection.
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©End
of Life Curriculum Project, a joint project of the US Veterans Administration
and SUMMIT,
Stanford University Medical School.
Funded by a grant to the Veterans
Administration Nationwide Palliative Care Network by
the National Library of Medicine. VJ Periyakoil, MD, Director.
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