Breaking bad news - delivery

Another alternative way to deliver bad news might be...

"Mrs Doherty, you are right. You do have a nasty chest infection that is making it hard for you to breathe. We call that pneumonia.  And you are right that we are giving you powerful antibiotics to try and kill the bugs in your lungs.

But, do you remember how you told me that your cardiologist was having a hard time balancing the medications for your kidneys and your heart failure? Well, since you havenít been well we have been having a really bad time at getting this right, and I donít think we are succeeding.

Pause.

Your kidneys and heart are starting to shut down.

Pause.

I donít think your body can recover from this.

Pause.

And although we are trying our hardest, you are getting slowly worse.

Pause.

Do you understand what Iím trying to say? Do you want to continue talking about it?  Do you have any questions Mr Doherty?

 

(Sometimes patients may want a moment alone with family members.  Other times they may have questions about the treatment so far, or questions about alternative therapies they may have seen on the television or read in the paper)

 

Pause

I want to reassure you this conversation doesnít mean that we are abandoning you.  We want to keep you comfortable and we want both of you to be involved in any decisions that are made about your care"

 

This patient may feel they are being condescended to

This patient may just want the health care worker to get straight to the point!

This health care worker is asking too may questions