Conclusion

• Clinicians often have to deliver bad news to patients.
• Both delivering and receiving bad news are intrinsically stressful events.
• Preparing in advance, carefully setting the stage and crafting an agenda and following the steps described below are helpful.
• Typical steps often used in delivery of bad news:
  • Warning shot : Tell them that you have some unpleasant news for them
  • Pause : Wait for them to take a deep breath and get ready to hear the bad news.
  • Deliver bad news:
    • Use short simple sentences.
    • Avoid common communication errors studied earlier
    • Be sensitive and compassionate
  • Empathic silence: Wait for them to intake and process the bad news.
  • Answer questions : The bad news will prompt a lot of questions. Answer them patiently
  • Assure nonabandonment: Inform the patient that you will be coaching them through the next steps
  • Make follow-up plans: Clearly elucidate the next steps
  • Debrief and self reflection.