Breaking Bad News

“Nurses might have to deliver bad news on the phone and it is also important to have excellent communication skills and be cautious of the best time and place to deliver bed news.”

Plaxedes takes us through how to break bad news and gives advice on what and what not to do.

Topics covered in this article

What Is Bad News?

What Are Some Of The Situations Classified As Bad News?

What Preparations Should Be In Place To Deliver Bad News?

Who Is Responsible For Delivering Bad News In A Health Setting?

What Skills And Knowledge Does The Nurse Need To Break Bad News?

How Do Nurses Prepare To Deliver Bad News?

Why Is It Important To Nominate The Person To Deliver Bad News?

What Support Is Offered To Families?

Other Points To Note

What Is Bad News?

Bad news is an announcement or information given about a distressing event which affects the receiver.

Receiving bad news can be debilitating to some individuals, resulting in life long physical health problems like depression.

In this article I am going to take you through the steps to follow when delivering bad news.

I am going to pay attention to delivering bad news following death of a loved one in a health facility setting.

What Are Some Of The Situations Classified As Bad News?

Sudden illness from a non-treatable disease where prognosis is poor.

Fatal accidents, or accidents resulting in serious, life changing injuries.

Sudden loss of property in fires or natural disasters.

Loss of a loved one; this could be sudden or after a long period of illness.

What Preparations Should Be In Place To Deliver Bad News?

A quiet room with minimal disruptions should be designation for the family before they come into hospital.

The Room should be warm and comfortable with an accessible phone.

The relative might want to call another family member for support.

A jug of water and tissues should be provided.

A separate member of staff maybe allocated to receive the family or relatives when they come into hospital.

Who Is Responsible For Delivering Bad News In A Health Setting?

A qualified Nurse or Doctor are responsible for breaking bad news.

What Skills And Knowledge Does The Nurse Need To Break Bad News?

The Nurse should be non-judgemental, show empathy, sensitivity and have an understanding of impact of losing a loved one.

The Nurse should also be very honest and use clear language when delivering the message, for example; ‘’I am sorry to inform you that X has died..”

The Nurse should then inform the family exactly what transpired.

The Nurse delivering the bad news should have good knowledge of the deceased person so they can respond to the relative’s questions.

Where possible, the Nurse who last saw the person or who was with the deceased when their condition started deteriorating involved in the resuscitation.

A Doctor or colleague may accompany them.

In some instances, the Doctor who was in charge of the patient has to be involved.

The Nurse should allow the Family Members some space or as much time as they wish.

This will give them time to absurd and process the bad news.

The Nurse should be tactful not to interrupt.

In some areas they have specially trained nurses with Counselling experience to deliver the bad news.

How Do Nurses Prepare To Deliver Bad News?

Breaking bad news following loss of a loved one is very distressing for both the nurse, family and relatives.

This is because to some relative’s death of a loved one comes as a shock, upsetting and deep sorrow hence the Nurse or the person delivering the bad news has to be prepared.

The Nurse will calmly and sensitively explain to the relative the time when the deceased ‘s condition started deteriorating and when the Doctor was called and eventually the Intermediate Life Support (ILS) team was called.

They might briefly explain about the resuscitation protocols followed and show The relative the room where attempts for resuscitation took place and show them the equipment used.

Why Is It Important To Nominate The Person To Deliver Bad News?

This is to ensure that the person prepares to meet the Family with all the information that might be required and also prepares the room.

What Support Is Offered To Families?

A member of staff will always remain in the room with them.

They might be asked if they needed any other support or help calling a Family Member or if they are able to travel back home on their own and if they have transport.

The Manager might be consulted where needed.

The Nurse should also be wary of the relative’s age, they could be a teenager or elderly who will require more support.

The Nurse should also prepare for a negative Reaction from shock to anger and possible aggression in some instances hence the need for a colleague to be present.

The Nurse may ask a colleague to remain in the room with them.

The Nurse will also explain the protocols which will be followed when one is deceased and the available contacts and that they can also contact the Nurse should they have any concerns or need more support.

The Nurse may signpost the Family to the GP or other Counselling organisations should they require further support later.

When the relative have settled the Nurse will go through the deceased property list and valuables to ensure they are all available and signed for.

Other Points To Note

Nurses might have to deliver bad news on the phone and it is also important to have excellent communication skills and be cautious of the best time and place to deliver bed news.

It’s important to check if the receiver has another family available or they are elderly.

Police have been involved in some circumstances to break bad news at people’s Homes. Read more about a Nursing Journey.