It’s never easy to give bad news. People in many professions have to do this: a teacher tells a parent that a child isn’t passing a class, a mechanic tells a customer that a car can’t be repaired, or a publisher tells an author that a book was rejected. However, people who work in healthcare face special challenges: they have to tell patients and families about serious or even terminal conditions. Here are three tips for nurses who have to share bad news.
Be able to control emotions
Understandably, bad news can be overwhelming for a patient. If the nurse or other healthcare provider is very emotional, that may overwhelm the patient even more. Before delivering bad news, a nurse should have a mental strategy for conveying the information, including dealing with the emotion. That can be tough, and a template or communication protocol can be very helpful.
Although it is never easy to deliver bad news, practice can help with strengthening the skill. Practice with a friend or colleague, and ask for honest feedback. While practicing, it’s important to work on word choices and tone. In addition, it’s important to remember to avoid jargon and remain compassionate.
Leave work at work, and rely on a support system
No one can do all of this alone; it’s important to have a support system. With a good support system, a nurse can ask questions and exchange ideas, receive praise and encouragement, experience camaraderie, and laugh. In addition to increasing physical health, a support system also helps healthcare workers avoid burnout.
Sometimes, even with a good support system and a careful attention to maintaining boundaries, a nurse may get very involved in a particular case. Giving patients a home number, checking in on days off, or feeling that no one else can provide the proper care are signs that you’ve lost your objectivity. If that happens, it may be time to step back and let another nurse take over for a time, if necessary. A support system can help with that, too.
There’s no right way, and every situation is unique
Although it’s important to practice delivering bad news to strengthen the skill, it’s equally important to remember that no two situations will ever be exactly the same. Some people cry, some get angry, and some sit quietly in numbed shock. Your job is to respond to their reaction and help them get through it.
No matter how the patient reacts, you must help that individual establish a plan. Encourage the patient to write down questions; there will be a lot of questions, and it can be overwhelming to try to keep track of them. Encourage the patient to tell friends and family; the individual might be resistant initially, but the support will be a big help during low points. Finally, encourage the patient to prepare for what comes next; it helps the individual to know a little bit about what to expect.
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