Communicating bad news

Communicating bad news

Sheila Broderick (1), Ruth Cochrane (2)

(1) Retired Women’s Health Counsellor, (2) Consultant Obstetrician, University Hospital Lewisham, London, UK

Introduction:
If you are the one who has to tell a woman and her partner that there is a problem with their pregnancy, you become part of their life’s experience. They might remember you: you will become one part of a sad and complicated journey as they learn to live with their new reality. No one wants to create even more distress for the couple, but if you communicate poorly you will be remembered for the wrong reasons. With experience and effort we can learn to do this difficult work well.

Description:
Communicating bad news makes some professionals fearful. Sometimes this fear interferes with their ability to do it well. Having to tell the bad news is not about you: it is about the parents, and the impact the news will have on them. This news will change their lives forever. Your ego needs to get out of the way. This task requires humility on your part. You need to understand and accept that no matter how well you impart the news, some people will be dissatisfied or angry with you. Why is this work difficult? Are we afraid of people’s reactions? Do we have expectations about how they will react? Are we more comfortable with reactions we recognise? People react in different ways: you may be criticised for gently leading up to the bad news, and then criticised the next time for coming straight out with it. Do we feel helpless? Feeling helpless does not mean that we cannot be helpful. We can be kind, and sympathetic. We can be a resource. We may become someone patients feel they can trust to care for them during the journey of this pregnancy and perhaps through a future one.

Summary:
Imparting bad and sad news is a challenge. By understanding our fears about this task – feeling helpless, or responsible, and not wanting to be the one who has to do it – will not enable you to make the bad news better, but it will give you a way into becoming more able to communicate as well as you can.

Ethics statement:
Ethics approval not sought, as this content describes our professional experience.

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