How Do I Give Bad News? c/o HospiceFoundation.ie

individual

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INTERPERSONAL : SCIENCES

humanistic -------------------------------------------  mechanistic

SOCIOLOGY : POLITICAL

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group-population

Level of knowledge and understanding empathy and rapport self-care Losses ... many forms ... shattered hopes, dreams, aspirations patient's reaction - anger, anxiety, blame, shock, helplessness, misinterpretation Acknowledge reaction diffusing anger... Respect denial of bad news awareness - understanding vulnerability It is good to use non-verbal cues to  convey warmth, sympathy,  encouragement or reassurance  to the patient. p.10. Bad news = information that affects the individual's identity - very existence -

Correct patient and family Plans to give - convey bad news - Multidisciplinary Team informed Records Telephone Bad news = information that affects the individual's future When to inform? As soon as information is known. Ensure environment - time protected, no interruptions, mobile phones ... At bedside, curtains closed, eye-level, volume of voice, deafness? Proceed at person's pace Give information in chunks Be prepared to 'fire warning shot' - 'telegraph' what may follow Diagnosis FUTURE prognosis Time and 'space' often need to be created and then protected (respected)

or that of a loved one. shock of others - family and risk of being overheard awareness - understanding social support strengths Shared resilience with acceptance A standard to use: If the person was my relative would I  have been happy with how the  news was given? p.6. How Do I Give Bad News? CULTURE & LANGUAGE INTERPRETER SERVICES

Sick child? p.16. Sudden death? p.20. Age of consent - 16 years old - 18? Right to: accurate and true information receive or not receive information decide how much information decide who should be present at consultations decide who should be informed about their diagnosis and what information they should receive Under no circumstances should you hand over personal belongings in a plastic bag. p.23.

Source:
http://hospicefoundation.ie
http://hospicefoundation.ie/wp-content/uploads/2013/04/How-Do-I-Break-Bad-News.pdf