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Breaking Bad News

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Breaking Bad News Dr Charlotte Clare Consultant in Palliative Medicine What is bad news? Any news that drastically alters a person s view of the future. – PowerPoint PPT presentation

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Title: Breaking Bad News


1
Breaking Bad News
  • Dr Charlotte Clare
  • Consultant in Palliative Medicine

2
What is bad news?
  • Any news that drastically alters a persons view
    of the future. Fallowfield 1993
  • Information that drastically alters a patients
    view of their future for the worse. Kaye
    1996

3
Various guises of bad news
  • Illness
  • Imminent death
  • Sudden death
  • Infertility
  • Altered body image
  • Loss of a job
  • Loss of a relationship
  • Failing exams
  • Loss of possessions

4
Why is it difficult?
  • Feeling incompetent
  • As professionals we like to make things better
  • We may fear their reactions
  • We feel unsure, vulnerable, what can we say to
    comfort?
  • Wanting to protect or shield the patient
  • Lack of time
  • Feeling powerless
  • The feeling that you have to do it
  • Getting blamed

5
Why is it important?
  • To maintain trust
  • To reduce uncertainty
  • To prevent inappropriate hope
  • To allow appropriate adjustment
  • To prevent a conspiracy of silence.

6
Breaking Bad News
7
10 Steps (1-3)
  • Preparation
  • - Know the facts
  • - Who present?
  • - Sit down
  • - Allow time
  • - Face to face
  • What do they know?
  • What do they want to know?

8
10 Steps (4-7)
  • 4. Allow denial
  • - How do you feel things are going?
  • 5. Warning Shot
  • - Clear language
  • 6. Explanations
  • - Narrow gap between their information and
    reality
  • 7. Elicit concerns

9
10 Steps (8-10)
  • 8. Ventilation of feelings
  • - Therapeutic
  • - Empathy
  • 9. Summary and plan
  • 10. Offer availability

10
  • Thank you
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