Nobody wants to be the bearer of bad news, especially if it involves a life-changing diagnosis. As a nurse, however, you occasionally will have to deliver bad news to patients. Depending on your nursing specialty, such as oncology or hospice care—you could be required to provide life-altering news to patients more frequently.
So, how does a nurse, the bearer of bad news, stay poised and calm when breaking this news to a patient or their family?
The right words can comfort and support a patient's most vulnerable moments. Fortunately, some therapeutic communication techniques in nursing can help nurses deliver grievous news to patients with compassion.
Keep reading for nine evidence-based tips on how to communicate bad news to your patients.
Tip One: Prepare Yourself
Imagine this: you are an oncology nurse, and you are the first point of contact to explain to a patient that their test results indicate a stage II diagnosis of breast cancer. Fortunately, the cancer has not spread beyond the patient's breast tissue and nearby lymph nodes. Still, it would help if you told your patient the news so they could evaluate their case further and discuss treatment options.
What's the best way to handle this situation as a nurse?
Before delivering any news, gather all the necessary information about their diagnosis to understand your patient's situation fully. According to an FPM journal by the American Academy of Family Physicians, nurses can feel more confident when providing bad news to their patients "by taking a systematic and individualized approach."
This may mean, after giving the news, asking a patient how they feel about their diagnosis. Also, being prepared to answer any patient's question about receiving a new medical diagnosis can help you feel mentally grounded during uncomfortable conversations.
Tip Two: Choose the Right Setting
Studies show that the social and physical environment should be considered when breaking bad news to patients. For example, discussing a potentially life-altering diagnosis with a patient in a private, quiet, and interruption-free environment is best. If permitted, it's also essential that a patient is accompanied by a person or family member they trust when receiving a life-changing diagnosis from a healthcare professional. When a patient is surrounded by one or a few people in their support network, this can help mitigate the emotional effects of a major health diagnosis.
Tip Three: Avoid Medical Jargon
When delivering bad news to a patient, a nurse should use simple and empathetic communication. This means avoiding using big words or medical jargon to explain a significant health diagnosis to a patient. Delivering compassionate and clear news also means avoiding vague language or euphemisms that could confuse or mislead patients from fully understanding their diagnosis. When in doubt, break down bad news into smaller, understandable parts for a patient.
Tip Four: Show Compassion
As a nurse, part of your job is maintaining a professional demeanor. However, there is also a time and place for more informal and empathetic communication. When explaining a life-altering diagnosis to a patient, acknowledge their emotions and feelings. Let a patient know that you understand and are there to support them. Sometimes, showing compassion and empathetic communication can be as simple as saying, "I am so sorry; I hear you; how can I support you?"
Tip Five: Give Your Patient Time to Process
In addition to breaking down bad news into smaller, more digestible pieces, telling a patient that they, for example, have a terminally ill disease can be overwhelming if delivered all at once. After giving your patient bad news, take a step back and give them time to process. Allowing your patient time to come to terms with their new, life-altering diagnosis can lessen the impact. Once a patient has had time to grieve and process their new diagnosis, you can approach them again and offer more information and support.
Tip Six: Provide Resources
As a nurse, it can be helpful to let patients know that there are resources and support networks to help them manage their new diagnosis. This goes beyond offering a pamphlet or two. As an empathetic nurse delivering bad news, you can aim to provide resources such as support groups, counseling services, or educational materials to help the patient cope. It's also a good idea to ask about a patient's personal support networks, such as family and friends, who can help them deal with their new diagnosis outside a clinical setting.
Tip Seven: Offer Your Ongoing Support
Depending on your role as a patient's healthcare provider, you can let a patient know you are available to provide ongoing support. Constant support may mean checking in on a patient regularly by offering nurse-patient communication through digital platforms such as video conferences and live chats to help patients stay connected and involved in their treatment care.
Tip Eight: Give the Patient Control
Similar to offering a patient ongoing support, a nurse can offer a patient a list of activities to give them the best quality of life after a major medical diagnosis. For instance, physical therapy and mental exercises can play a vital part in developing a treatment plan that leads to a patient's best possible health outcome.
As a nurse, you can also help patients take control of their treatment plan by offering a comprehensive list of treatments to support their recovery or life after diagnosis. Furthermore, studies indicate that patients are more likely to follow their treatment plans if they actively participate in decision-making. As such, clinical care may be more effective when a patient feels motivated to stay involved in their treatment plan.
Tip Nine: Practice Self-Care
Nurses often only consider the repercussions of delivering bad news to patients and their families. However, being the bearer of bad news can also affect your emotional well-being if you are a nurse.
Make sure to take care of yourself by seeking support from others and engaging in self-care activities. You may be able to find support with in-house therapists or resources that offer guidance and support for nurses.
Additionally, many mental health apps can help support a nurse's well-being and mental health during high stress. Ultimately, if you are a nurse who feels highly overwhelmed by the pressure of delivering heart-breaking news to patients, you should always reach out for professional guidance.
Communicating Bad News as a Nurse
Are nurses the bearer of bad news? Yes, sometimes. Nurses may even say that delivering bad news to patients never gets easier. However, there are many ways for a nurse to approach this process with empathy and clear communication to ensure that patients feel fully supported when receiving life-altering news.
Learning how to integrate interpersonal skills in nursing, such as active listening and nonverbal communication, can also assist nurses in compassionately and effectively communicating critical news to their patients. Also, remember to give yourself room to process, especially if you are a nurse whose specialty requires them to have those hard conversations with patients daily.
Want to learn more? Here are a few other practical communication tips on handling difficult patient conversations.
