Breaking Bad News

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Bad news should be delivered in a sensitive manner by someone who is well informed about the particular case/circumstances. The following guidelines have been adapted from the Department of Health , Social Services and Public Safety – Breaking Bad News , Regional Guidelines. Preparation Prepare yourself - It is natural for the bearer of bad news to be anxious about the interview with the patient or carer. • Familiarise yourself with the patient's background, medical history and test results. You will also need to have some knowledge of the choices in the future management of the patient's condition. • It is helpful to mentally rehearse the interview, the likely questions you will be asked, the patient's emotional and potential responses. • While it is important to remember that the bad news may be very sad for the patient, the information that you will be giving will be important in allowing him/her to plan for the future. • It is strongly recommended that a colleague such as the patient's named nurse or specialist nurse accompanies you. This individual may remain with the patient if appropriate and help provide continuing support to the patient. • The patient may want a member of their family with them, however this must be established prior to the interview. The clinician must be guided by the wishes of the patient. It can be helpful to suggest to the patient, when investigations are being carried out, that they may wish a family member or friend to accompany them for support, when results are discussed with them. Prepare your setting - • Arrange some privacy. Ideally an interview room or where a patient is confined to bed, pull the curtains around the bed. The latter is not an ideal situation, but can occasionally be difficult to avoid. (A practical hint is to have some tissues at hand in case the patient becomes upset.) • Do not stand over the

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