Skip to main content

Taking The Sting Out Of Bad News

Image
By
While the news may be bad, the manner in which it is delivered can make it either traumatic or bearable, says Dr Elly Hann, an expert on end-of-life care programme.  And what is interesting is that the technique applies not just to patients detected to have cancers, but to any bad news like loss of a job, failure in an examination, or a failed relationship,
It is being increasingly realized that bad news, no matter how bad, needs to be told rather than concealed, as getting to know it helps the patient or victim to cope better and set realistic goals. Recent research contradicts traditional belief that it takes away hope plunging people in irretrievable despair. That is of course if the news is communicated properly.
The currently accepted technique of delivering bad news that we might all find universally useful in our own lives, has 6 steps.
Step1: Getting started. A little thoughtful preparation needs to go into ascertaining and reconfirming the unpleasant facts before telling them and in creating the right environment, ensuring adequate time and deciding who else needs to be in the room. Breaking bad news, such as the test report showing cancer, cannot be done with frequent interruptions by cell-phone calls, or in a crowded room,  or in haste as while rushing to work on the corridor. You would realize that similar factors would apply while you tell your son about his poor results in an examination or discuss a breakup with your romantic partner.
Step 2: In this step one explores what is already known. The patient may be aware of the diagnosis and may be seeking a validation.
Step 3: is finding out how much the patient wants to know. In Asian cultures, an elderly woman may not want to know the diagnosis, and may delegate the responsibility to her eldest son to find out and decide further. Her wish needs to be respected.
Step 4: is the actual sharing of the information. It should be straight-forward but delivered with sensitivity. It is useful to give a few warning shots such as “The results have come. I am afraid the news is not good” or “I have something serious to discuss with you, unfortunately it is not good news” . Then the news needs to be stated, briefly, clearly and unemotionally. Then WAIT. Let it sink in and let the patient emotionally process the information. Non-verbal communication, such as putting your hand on his shoulder, is of more value at this stage than a long flow of words which the patient may have stopped listening to. Start speaking only when he has responded.
Step 5: is to respond to the feelings that the bad news generates; it can range from depression, anger, and guilt. One needs to be a good listener at this stage, allowing the patients verbal emotions to flow.
Step 6: is to offer follow up and to reassure non-abandonmnent. Break up of a relationship can be hurting, but to decide to part on pleasant terms without animosity or hostility, and remain in touch as friends, will ensure a smoother life ahead for both.
Let us try to take the sting out of bad news in our clinics, homes and offices.
 As published in HT City (Hindustan Times) dated 21 november , 2010.

Labels:

Comments

Post a Comment

Popular posts from this blog

How do you like your Tea?

By
The way we drink our tea may not only reflect our taste and style, but our health as well. Tea drinking is around 4700 years old and had its origin in China. Leaves of the shrub Camellia sinensis (tea plant) were in use at that time as a remedy for wounds and diseases. With the legendary emperor Shenong brewing and drinking its extracts, tea drinking became a popular habit in this part of the world. The British, impressed with the brew and the customs that go with drinking it in China and Japan, tried to emulate and evolve a tea-drinking custom of their own, and soon “tea-time”became a familiar term across the globe. Every home or cafe seems to have its own flavour. The north Indian variety of “chay” is a glass of hot creamy milk (more cream as it gets more “special”) with lots of sugar and a lacing of  “tea liquor” of strong tea that grows on lower heights (Assam, Nilgiri, Sri Lanka etc). In contrast, the Chinese and Japanese prefer light green or jasmine tea without a drop of mi...
Post a Comment
Read more

Food Fads in Liver Disorders

By
In an attempt at trying to do well to those they love, spouses and parents often enforce diets on patients of liver diseases that often turn out to be detrimental. The commonest food fad is pale insipid boiled cabbage being doled out to nauseous patients suffering from hepatitis that makes them puke even more.  The liver, in a way, is a buzzing manufacturing unit that requires lots of energy to keep its multiple functions going. And it derives all this from the food we eat. During disease, such as during an attack of jaundice, when many of the liver cells get killed, the liver attemptsdamage control by trying to regenerate quickly. For its cells to multiply however, it requires a generous supply of energy that comes from carbohydrates, and protein, the building block for its cells and tissues. Boiled green vegetables unfortunately have neither of these. Hence the situation often progresses to that of a starved liver unable to recuperate due to cut-off food suppl...
2 comments
Read more

Colas have No Class

By
Cola drinks, once a symbol of American upmarket style, is now to be found perched mainly on the shelves of road-side ‘paan walas’ and local grocers. True, there still are Americans who drink more colas than water, and consume an average of 2 bottles per day of the tangy fizzy dark drink, but it has clearly fallen in stature as offering it to visitors or serving it at parties is no longer elegant. Premiere schools in Lucknow such as La Martiniere College for girls have shunned colas from their canteen for the last 4 years. The story started with extensive campaigns by HOPE Initiative (Health Oriented Programs and Education) in 2005 creating awareness among the bright students about the long term harms of cola drinks. A heated debate followed in which the rights of an individual student  was pitched against the hazards of allowing gullible youngsters to be enticed by aggressive marketing to gulp colas and fall sick. The intelligent and alert La Marts students dcided on ...
Post a Comment
Read more