Breaking bad news—guidelines Flashcards
For unexpected death, e.g. motor accident
DOs
Personal contact of relative/s, preferably by doctor.
Be well-prepared: check facts, plan approach.
Use suitable quiet private room (not to be disturbed).
Provide empathy, support, understanding, sensitivity.
Be honest, direct.
Allow time, opportunities to react and question.
Allow silence, touching and free expression of emotions.
Allow viewing of a dead or injured body.
Provide appropriate follow-up and ongoing support.
For unexpected death, e.g. motor accident
DON’Ts
Delay contact.
Rush the interview.
Avoid fudging.
Be blunt.
Withhold the truth or get facts wrong.
Give platitudes and euphemisms.
Give false reassurance.
For sharing bad personal news
Plan the consultation, check facts, set aside ample time.
Meet in an appropriate room with privacy and no interruption.
Ask pt if they would like company (e.g. a relative or friend).
Make good eye contact and be alert for non-verbal responses.
Use simple, understandable language.
Be honest and diplomatically to the point (don’t cover up the issue).
Allow time, silence, tears or anger.
Avoid inappropriate methods (refer to ‘Dont’s’ above)
Don’t give precise predictions about life expectancy.
Seven-step protocol for breaking bad news
Assess pt’s interest in and capacity for detailed information.
Establish pt’s beliefs about the illness and what he or she wants to know.
Provide accurate information in small doses, checking regularly what has been understood.
Monitor how pt feels about the problem and what has been said.
Repeat the messages as the illness progresses, especially after each new step of management and/or deterioration.
Involve family members as much as pt wants.
Plan for continued involvement.
Assure continuous contact with the pt.
