Breaking bad news


University Nursing Flashcards on Breaking bad news , created by katherinethelma on 20/02/2014.
Flashcards by katherinethelma, updated more than 1 year ago
Created by katherinethelma over 10 years ago

Resource summary

Question Answer
Crawford D et al (2013) Educating children’s nurses for communicating bad news The way news is disclosed can affect the way news is accepted and the level of support the family will require. The importance of clarity, honesty and empathy is emphasised.
Crawford et al (2013) Advice for student nurses on delivering bad news Enhance communication skills by exposing the children’s nurse to clinical areas where bad news is given frequently and is not a rare event. e.g neonatal intensive care, children’s intensive care, oncology etc. to enable the student to witness first-hand how clinical experts deliver difficult information. Maintain a confidential and anonymous diary, log book or reflection journal to critically evaluate how their communication skill sets are developing.
What is bad news? Bad news can mean different things to different people Theorist have defined bad news as: Buckman (1984) Any news that alters the patients view of his or her future Arber and Gallagher (2003) Any information which is not welcome
Role of a childrens nurse in breaking bad news The children’s nurse, as an instrumental member of the multidisciplinary team caring for the child and family, is central to this complex communication process
The NSF and breaking bad news States how the manner in which the news is relayed to parents impacts upon the way it is received and accepted. (DH, 2003).
6 Styles of BBN (Martins and Carvello, 2013) 1. Inexperienced messenger (Lacks experience & knowledge of pt condition and situation) 2. Emotionally burdened expert (Kind but cannot cope with own emotions) 3. Rough and Ready Expert (Information presented in sharp, harsh manner. No regard to pt knowledge or emotional impact) 4.Benevolent but tactless (Expresses sympathy but little or no empathy) 5. Distanced expert (Communicates objectively but little emotional understanding of pts perspective) 6. Empathetic Professional (Balances the nature and pace of communication with the patients physical and psychological response)
What style of BBN do pt's prefer? (Martins and Carvello, 2013) There was no one style that suited everyone. No patients preferred the "rough and ready" style, the majority of pts preferred "empathic professional" but just because the majority liked empathic professional approach does not mean it will suit everyone e.g some patients liked distanced expert/emotionally burdened Highlights importance of individualised care
How nurses can be supportive to other professionals during BBN (Working as part of MDT) An open nurse who enquires and responds appropriately to how the clinician feels may contribute to reflective practice, improvement and emotional well-being (Shaw, 2012)
Role of the childrens nurse in BBN (RCN, 1999) Manager/leader Before breaking the news Prepare self/family Prepare venue and consider privacy Liaise with doctor Ensure X-rays, results, & information leaflets are available Organize the necessary people to be present Allocate another member of team to care for the child After breaking the news Ensure follow up as required Document clearly in the nursing notes
Role of a Childrens nurse in BBN (RCN, 1999) Facilitator/supporter During the meeting Support the family Show empathy/be attentive Take notes for parents if desired/ app Ensure parents have time to express their emotions Act as a supportive presence for the doctor during interview Immediately following meeting Give choices, do they want to be left alone? Answer any questions they may have, clarify any points, use simple language
Role of childrens nurse in BBN RCN (1999) Teacher/Educator Provide family with any further information they require Provide practical help and written information to back up verbal information if appropriate Ongoing evaluation about knowledge of condition
The role of the childrens nurse in BBN (1999) Advocate/Team player Communicate with other members of the MDT Document and record in nursing notes Promote needs of child/support parents regarding how and why to tell their child
Rabow and McPhee’s (2000) ABCDE mnemonic of BBN Advanced planning Building a therapeutic relationship and environment Communication Dealing with reactions Encouraging and validating emotions
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