Irish Hospice Foundation
Toolkit for Compassionate End-of-Life Care
13
Breaking bad news over the phone Ideally , bad news should be given in person . However, there may be times when this is not possible, and you have to deliver the news over the phone. ink of breaking bad news as a process, not as a single event. It may take the person several conversations before they are able to grasp all that you are saying, especially if the information is complex.
Here are some tips for breaking bad news over the phone:
Step 1: Prepare yourself • Prepare, mentally and emotionally - think about yourself, the person receiving the news and the news itself. • Set time aside. Find a quiet private room to call where you can avoid interruptions. • Know the facts. Make sure you have the right person and the right results/news. Have options or treatment plans prepared to discuss with the person as appropriate. Step 2: Make a good connection • Identify yourself. Tell them your name, your role and where you are calling from. • Confirm whom you are speaking to. • Ask the person if they are sitting down and if anyone else is there with them. 2 • If you are delivering news of a death, then go to Step 3. • Find out what the person already knows: “How have you been since I saw you last?”, “What do you already know about your illness?”, “What do you know about how your mother/wife is doing at the moment?” • Find out how much they want to know: “I have your results—are you the sort of person who likes to know a lot or a little?” Remember that they have a right to know and to NOT know. Step 3: Prepare them, and then be gentle as you deliver the news • Prepare them for what is coming next: “I wish I had better news to give you today”, “I’m sorry, but the news isn’t as good as we’d hoped it might be”, “Unfortunately, I have some bad news for you”. • Pause. Allow the warning to land. • Gently deliver the news using clear simple language and avoid jargon and euphemisms: “ e lump in your breast is cancer”. • If the news is complex, break it into small chunks and check that the person understands each chunk: “Can you tell me in your own words what you understand we have talked about?”
Communication 2
2. Buckman R. (1992) How to Break Bad News: A Guide for Health Care Professionals. University of Toronto Press, Toronto
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