Delivering the Bad News: The Most Difficult Nurse Task

The nursing profession is a very difficult, challenging, and stressful job. Nurses spend long hours doing their job to help patients recover from their illnesses. Taking care of the patients and making their stay in the hospital comfortable are some of the daily tasks nurses do. However, no one likes to be the bearer of bad news.

No matter how hard the nurses try to help patients recover from their illnesses, some of them die because of complications and severity of their condition. It’s beyond the nurse’s control and they accept the fact many people also die in the hospital but telling the bad news to the patient and his/her loved ones is a different story.

It’s a fact that the “bad news” may drastically and negatively alters the patient’s expectations and his chances of recovery. Once the diagnosis has been made, the doctor and the nurse must find the right means of delivering the news to the patient by preparing them of the possibility of a bad outcome. If someone is suffering from a stage four lung cancer then it would be wise to condition the patient’s mind about the medical reality in a more humane manner.

There should be an open line of communication between the patient and his/her family with the nurse and physician regarding all possibilities thereby laying a foundation and trust. The nurse-patient relationship is important here because the nurse can provide the important things the patient needs to know about health issues. Good communication is the key in nurse-patient relationship because there are many distractions that can interfere in the process.

Here the important steps in delivering the bad news to the patient:

1. Find the right time and place to say it
Once the nurse has developed a good relationship with the patient, the meeting has to be facilitated in such a way that the doctor, the family members, and the nurse are all present.

2. Find out what the patient knows
The patient’s health condition may deteriorate if he/she believes in partial truths and misinformation. If the person thinks that he/she has about six months to live then anxiety may set in thereby worsening his/her condition even if there is still chances of survival.

3. Find out what the patient wants to know
Before, doctors really felt it inappropriate to tell the patients the severity of their condition because it was the common thought then that the patients don’t want to know that they are suffering from a serious illness or they have few months to live. But recent studies have shown that up to 97% of patients want to know the truth about their illness even if it’s bad news to them.

4. Simplify things
The patient simply doesn’t understand technical and medical terms right away. The nurse should talk in a layman’s point of view. There is no need to give them information that they already know. The nurse should provide options to the patient as to what specific course of action should be taken.

5. Respond to their feelings
Consider the patient’s feelings when breaking the bad news to them after all it would be a great anxiety for them to hear it. Help them understand the situation, so that they begin to accept the situation better. The patient has the right to make his/her own decision because whether if it’s right or wrong, the patient’s decision must be respected. Some patients have a “no-resuscitation” clause even if there is slim chance for a cure.

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