Breaking Bad News

1. Breaking Bad News Robert Buckman’s protocol for letting someone know something that they don’t want to hear

2. Getting Started • Private with Doctor and patient sitting comfortably • “How are you feeling right now?” • Anyone that the patient would want present?

3. Finding out how much the patient knows • Details are important • “What detail would you like to hear?” • Specific or general • Keeps the patient (a person) as the priority • “What have you already been told?”

4. Sharing the information • Have agenda in mind before sit down • Topics could include: • Diagnosis • Treatment • Prognosis • Support or Coping • Focus will be on one or two • Information should be given in small chunks • Long lectures are overwhelming and confusing • Translate medical terms and avoid teaching pathophysiology

5. Responding to the patients feelings • Must respond properly • Caring physician • Acknowledge the reaction • Go with reaction • “Could you tell me a bit about what you are feeling?”

6. Plan follow-through • Outline a step-by-step plan that will be carried out in the patients system of health care • Be explicit about the next contact with the patient • Arrange a means of contact if needed • Probably will (questions/concerns)