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Home GuidelinesGiving
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Even when bad news is expected, there will be an element of shock when the reality is put into words. This may last only a minute or two but may last for a considerable time, depending on the seriousness of the news and its impact on the recipient. During this time, the patient is unlikely to retain any further information or even hear what is said. For this reason they need space, and time to think before any progress may be made.
During this time, the patient may be still and silent. It is a temptation to fill this space with more information, reassurance and hope. What is required is that the silence be respected. If it goes on for long, you could say what you see:
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This news seems to be hard for you to take in.
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You seem to be quite shocked.
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I guess you need some space to take it all in.
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These statements are all educated guesses, but are useful in that
they break what may otherwise be a difficult silence, and also give
the patient the opportunity to express their feelings, if they are
ready.
In a busy clinic, it may be difficult to give enough time to someone who seems unable to grasp the situation. It might be possible, then, to suggest that the patient sit outside and when ready, talk to the specialist nurse. This team approach can be very successful and means that the person handling reactions may not be the same as the one who breaks the news.
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