Nurses and Breaking Bad News

When a patient dies or is diagnosed with a ‘life-limiting’ illness, doctors and nurses have the responsibility of ‘breaking the bad news’ to the family. A study by Warnock in April 2014 and published in the Nursing Standard worked to analyze the goings-on when it comes to breaking bad news.

Entitled “Breaking bad news: issues relating to nursing practice”, the study looked at several key aspects that have since put the event in a new perspective.

It is a process.

For the longest time, this was considered merely procedural. Attending staff are advised to keep an emotional distance from the event and be over with it so as to give the family time and space to process the information. Warnock believes this is wrong. Rather, it is a process which entails time and space beyond the hospital setting. Nurses have to walk people through what they are experiencing. It should not be a ‘fire and forget’ or one-time event but rather a gradual dissemination of information. ‘Bad News’ can refer to not just diagnoses or prognoses but rather encompasses a wide range of information that the family needs to know. To dump all that on them at one time borders on apathy. This leads us to the next point.

Knowing what to say and when to say it.

It is impossible to know in advance how news may be received. From that standpoint, we cannot presume all news concerning health to be bad news. An example given by the paper is as such: a man is informed that he will undergo an operation. This may be good news which means that there is hope or bad news that implies he is very ill. Nurses have to learn how to manage the flow of information. In a way, they have to be able to recognize the type of information they are dispensing. Honesty is sound policy but may not always be best when it comes to medical information. While some patients would prefer a more direct approach, nurses should develop