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Home GuidelinesHandling
reactions |
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Remember, Bad News will cause a shock reaction, even if it is expected. The patient will need time to absorb the news before they react to it. Ideally, the patient should be able to sit quietly, perhaps with a cup of tea, before disclosing their reactions, fears and worries. The shock may last only a few minutes, but sometimes may last longer and mean that the first reaction is an inability to talk about their feelings. Even in a busy clinic some time should be allowed for bad news to be absorbed. Resist the temptation to fill the silence with more information, since it is unlikely that more information will be retained by the patient at this time.
Patients and their families react in a variety of ways when they hear bad news. Typical reactions include anger, guilt and blame, fear and anxiety, tears and sadness, along with grief and the need to escape from the situation. For those who have to relay the bad news to other family members, there is the emotional conflict of handling the situation, and the feeling of responsibility that this carries.
Outbursts of strong emotion may be directed at members of the health care team, and it is important to realize that these are seldom meant personally. The patient, and their family need time to adapt to the new situation. Reactions need to be acknowledged and handled in a sensitive way.
It is important to listen attentively, and to acknowledge their reactions.
Use open questions to encourage them to disclose their feelings, worries
and concerns:
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This must be difficult for you. Can you tell me how you are
feeling?
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I can see that you are angry, and I guess I would be too,
in this situation.
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You seem frightened. What is it that you find frightening?
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Tell me more about how you are feeling just now.
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What worries you most?
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What does this news mean to you?
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Although we may see the various reactions to bad news as "normal",
each person will believe that their feelings are unique. It does not
help to tell them that most people feel like they are feeling. Rather,
we should acknowledge and work with individual feelings. Comfort can
be derived from simple supportive measures, such as appropriate touch,
an empathetic approach or even a cup of tea, if this is possible.
Think of a patient that you have cared for, where they became emotional.
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How did you handle the situation?
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How differently might you respond to an emotional outburst
now? |
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