Delivering Bad News
| Delivering Bad News: Helping your patients retain dire details| Modern Medicine Oct 1, 2009| | The purpose: This article focuses on providing healthcare professionals with suggestions that will help their patients remember important information immediately after receiving bad news. Although nurses usually don’t deliver the bad news, they are often in the room when it is given and are often the person that has to give the patient instructions immediately afterward. Research supports the fact that patients might not hear much of the nurse or physician tells them at this time, therefore they retain very little of the valuable information.
Patients with poor prognoses are especially at risk and retain even less than patient with fair to good prognoses. This research also revealed that the more information given to the patient the less they retained. Information data: The first suggestion that will help patients retain information in the event of bad news is to prepare the patient ahead of time for how they will hear the results. Ask them to bring a spouse, supportive friend or a tape recorder. The second suggestion is to have a face to face conversation with the patient. This will enable you to watch the patient’s body language.
Nonverbal language plays a big role in the assessment of a patient’s well being of state of mind at the time. This meeting should be during a reserved time period, so that you or the patient doesn’t feel rushed. A third suggestion is to decide on a few key points to make and stick with presenting these few only. Giving a patient too much information will result in them retaining even less. The fourth suggestion is start with the prognosis, not the diagnosis. Say something like “you have a condition that is very treatable with medication. If it is a grim diagnosis start with empathy and then convey the commitment to the patient. State “we’re here to talk about what the test showed and I want you to know that I am committed to working with you closely throughout the course of your treatment. ” The fifth suggestion is use simple language so that the patient can understand what is being explained to them. Many times Dr will use many words that the patient’s just don’t understand. It is important to remember that everyday language in the hospital or Dr Office setting may not be so in the everyday setting for the patient.
Explaining valuable information in a language that patients can understand is important in helping them retain the information. The sixth suggestion is to use a “teach back” or “chunking and checking” teaching strategy. This method gives the patient a small piece of information and asks them to explain it back in their own words. One good way to do this is have them explain to you how they are going to relay the information just give to their spouse or another family member not present at the meeting. Another way would be for them to show you how they are going to teach others about their treatment plan.
The seventh suggestion is to use handouts in simple language as supplements to verbal teaching. These work well as references that can be referenced at a later time. The eighth suggestion is to give the patient resources to help them with further coping. Resources such as websites, support groups or social workers can be very helpful in promoting coping. The ninth and finial suggestion is to set up follow up visits to assess how the patient is feeling as well as answer any additional questions the patient may have.
This is very important in order make the patient feel as if they are not alone in dealing with this issue and that you are committed to working closely with the patient throughout the prescribed treatment. Conclusions reached by author: Today healthcare providers are doing better at communicating information, but there are still areas to improve. These nine suggestions have contributed to the improvements and will continue to impact the way healthcare professionals communicate.
In the authors opinion the most important thing is being honest and open. As nurses it is important to take the time to get to know the individual and appreciate the journey with the patient. Critique This article was very easy to read and had a good flow with the presentation of the information. I was able to read the article easily and did not have to stop to clarify much of the information. I liked that the author summarized the suggestions in a numbered list at the end of the article. This made it easier to present each suggestion in my summary.
The article seemed to be more directed at Physicians, however I think the suggestions could be very valuable to any healthcare professional involved with direct patient care. Any healthcare professional that is involved in the teaching or communicating the treatment plan to the patient could benefit with the application of these suggestions. As a nurse I can apply these suggestions anytime I need teach patients about treatment plans. Good communication is a very important skill to develop and will be beneficial not only with the patients but with coworkers as well.
