How to deliver bad news
Definitions & Key takeaways
It's important to remember that the way you deliver bad news can have a huge impact on the person receiving it. Here are some tips for delivering bad news in a way that is respectful and compassionate:
- Be honest and upfront. Don't try to sugarcoat or downplay the news.
- Use plain language, and be specific about what has happened.
- Don't rush or speak too quickly; take your time and make sure you are understood.
- Acknowledge the person's feelings, and let them know that you understand how they must be feeling.
All right. How are you feeling today?
Hey guys, Drai, here from osmosis. And today what I wanted to talk to you about was kind of three tips on delivering bad news and bad news could be, you know, a wide variety of things.
It could be, you know, telling someone that someone has died, a loved one has passed away. It could be, you know, just saying that things are really serious.
Maybe they're not doing as well. It could also be a medical error, maybe, maybe a mistake has been made by the team and you're trying to figure out a nice way or a suitable way to tell a family about that.
So any of those things are possible and I'm gonna share three tips in my experience that have helped me deliver bad news to, to parents, to families, to Children themselves.
The first thing that I would say is that I'm going to give you kind of do s and don'ts and they kind of go together. Um And for each tip there's a do and a don't.
So the first step uh is make sure that you are able to take a deep breath and create mental space for the thing that's about to happen.
So before you step into a room, one thing that I always do is I just kind of count down kind of 321 in my head. Kind of really focus on what I'm about to say.
So that when I go in there, my mind is fresh, I'm clean. I'm not thinking about something else.
I'm not distracted. That's the do is kind of just make sure you center yourself and that you have enough time and space to have that conversation.
Uh The don't is the opposite of that. So don't be distracted, right?
So give uh take a moment to, you know, mute your cell phone. Uh I often like to give my pager away to someone that I trust so that they can hold it while I'm in there having a conversation.
Uh Really just making sure that there's nothing that's going to distract you from, from having a chance to explain to this family to this patient what's going on.
So that's the first thing. Uh tip number two is make sure that you are direct and specific.
Um You want to make sure that you're not kind of using vagaries. You want to just really be as, as detailed uh about what's happened, everything you know, as you can.
And the don't that kind of goes with that is make sure you don't uh be vague. Don't be vague.
Don't assume things make sure you stick to the factual timeline as you know, it, uh, people are really gonna kind of appreciate that.
Um, next, the, the last tip in terms of what you should do is make sure that you're listening well, and that you're receptive to what's being said, uh Both kind of the words that are being spoken, but also the mood in the room that you're really kind of feeling the mood and that you're in alignment with what the person is experiencing as far as the, don't make sure that you're not getting defensive.
Uh If, if they say, hey, you know, I wish that the doctors had told us, I wish that the nurses had done XY and Z take that in stride and say, yeah, II can understand that, you know, I can understand where you're coming from.
That makes sense. Uh Don't get defensive about it.
Don't say, well, you know, we did the best we could or, you know, anything like that. So, uh again, make sure that you're really listening, that you're being empathetic and that you're really feeling where people are coming from and that's not really a place to have a conversation about your side of things.
So don't get defensive, don't try to point out all the things that, you know, you did that were right, you know, anything like that really take whatever comes at you in stride.
And so to really ground this, I want to give a very personal example of when I've given bad news, I was in Lesotho, a small country in Africa, South Africa, um surrounded by South Africa and I was working in the clinic and a patient came to me, it was uh a woman and her child.
Um the child was, you know, about a month old. And when I did the physical exam, I unwrapped the baby because the baby was under a blanket And II put my stethoscope on the, on the baby's chest and the baby was um, was warm, uh which is normal, but there was no heartbeat at all.
There's no heartbeat, there's no respirations. And in the moment my, my brain, you know, triggered and I said, oh my God, this child just recently died, right?
We did rounds of Epinephrine chest compressions, um the whole the whole bit and the baby did not survive. So I had to go back to the mom who didn't know that the baby had died.
And so we wrapped the baby up just as the baby was and I brought her out and um kind of basically walked through exactly what happened.
I said, you know, when I first, when you first arrived, uh this is what II understood. Uh based on what you told me, you said that the baby had diarrhea uh and was dehydrated.
When I examined the baby, I noticed that there was no pulse. I took the baby quickly back.
I did chest compressions, you know, we gave Epinephrine and the baby's heart has not started. Um And so the baby has died and the mom, as you can imagine, was horrified by this news and I sat there with, with her, uh and we had a translator and it was just a very heart wrenching experience that will sit with me for a long time.
Uh But, you know, we just kind of held, held hands and talked about um uh basically what I think it happened and, and it was just a very, very traumatic thing for, for mom to go through, of course, and for me to go through frankly.
And so afterwards, you know, I have to decompress and kind of take this all in as well. And even when I think about it, it really kind of makes me emotional, but it's a hard thing, you know, going through bad news for a family for a child especially is just, it's tragic and it's hard and the more you can just kind of be in that moment and, and stay in that moment and not try to escape or run to the next thing or allow your brain to kind of wander.
Um I think the more help you can be to the, to the family that lives on in that situation or in a situation where it's a medical error to be with the family as they cope with, with whatever has happened.
So that's my advice. Those are my three tips.
Um Again, take a moment before you go into a room to gather yourself to be in that really uh very uh sacred space when you're in the room, make sure that you are very clear and, and accurate with what you know, and don't assume things and then afterwards make sure you're listening and being empathetic and really feeling out what, what the questions may be that come.
Um So I'll leave you with that again if you want to uh share with us anything about how uh this video, you know, is, is of value to you or more specifically pictures of how you're using osmosis in your studies to help you be better clinicians.
I'd love to see that and I appreciate that. Take uh take care.
Bye bye, start your free trial today at osmosis.org.
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