My mentor once told me that as an oncologist, I'll share bad news with patients more than 10,000 times throughout my career. Whew. How tough is that? For both us as clinicians and for the patients and their families on the other side of this news. How do we best support our patients in those challenging moments of sharing bad news?
Make sure you're in a private space, such as a clinic room, hospital room, or conference room. Don't deliver bad news in a hallway, waiting room, or other public space.
It's crucial to set up support for your patient in advance. The uncertainty of receiving bad news unexpectedly can be overwhelming. Arrange a family meeting so loved ones can be present. Encourage the patient to call or video chat with a loved one to listen in. If you're in the hospital, invite the social worker and nurse to join if they can. This proactive approach can provide reassurance and reduce anxiety for the patient.
Sit down and remove distractions such as your phone or computer, if possible. Be present with the patient and their loved ones.
Avoid jargon or confusing language as much as possible. It can be so hard to share bad news clearly, and it's a normal instinct to want to protect your patient by not sharing everything you know. I find that patients wish to have all the information on the table to plan for themselves and their families. If you don't know what specific results mean in terms of prognosis, ask an expert who does before the meeting if possible.
Offer a statement of support. Say something like, "This is really difficult, and we are here to support you. We will support you and your family each step of the way."
Give patients and families time to process the information without having to rush to make a decision. If possible, follow up with the patient in a few days, or if the patient is in the hospital, swing by later in the day to follow up.
If you're not the doctor who will be caring for them in the weeks or months to come, make sure they have quick follow-up with a specialist to help guide them.
Sharing bad news is hard for us too. Take time to reflect, journal, and process it all. Go for a walk. Listen to music. Expect you'll feel exhausted at the end of your day. Take care of your heart.
Thank you for continuing to care and for providing compassion to patients when they need it most.