{"id":4089,"date":"2025-06-09T18:03:36","date_gmt":"2025-06-09T17:03:36","guid":{"rendered":"https:\/\/dev.twentytwo.digital\/ukbodytalk\/?p=4089"},"modified":"2025-06-09T18:53:47","modified_gmt":"2025-06-09T17:53:47","slug":"how-to-deliver-bad-news","status":"publish","type":"post","link":"https:\/\/dev.twentytwo.digital\/ukbodytalk\/resources\/general\/how-to-deliver-bad-news\/","title":{"rendered":"How To Deliver Bad News"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">I\u2019m hosting a masterclass later today for Consultant Oncologists on delivering and discussing \u2018bad news\u2019 with patients.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">When asked, I was hesitant; I mean, these amazing professionals have to deal with difficult conversations on a daily basis and as a communication skills lead, I\u2019m stepping into territory that could potentially patronise and offend. &nbsp;Subsequent conversations with friends and relatives, bolstered by lots of mind-bending research, showed there is indeed a need and a desire for more training in this area.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Most of us will experience the \u2018I\u2019m sorry it\u2019s not good news\u2026\u2019 medical conversation at some point in our lives, if not personally, then with someone close.\u00a0 My own recollection of sitting in a consultancy room when my husband was diagnosed with cancer is that I can\u2019t remember much; I literally couldn\u2019t hear what was being said, which as it turns out is not uncommon because when we receive bad news the physical and emotional symptoms are similar to what we experience when an aeroplane nose dives. We panic. Heart rate rockets, hands are sweaty, our fight or flight mechanism steps in and this can cause us to make irrational decisions.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Shockingly, <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC5578619\/\">research has shown that if the patient feels that the conversation is not done \u2018well\u2019, then it can lead to a refusal to be treated.<\/a> The research I\u2019ve found suggests that in any challenging or potentially devastating situation, there are steps that can be taken to maximise better clinical outcomes. And it all comes down to excellent communication that puts the patient at the heart of the story.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Thankfully, these are not conversations we are likely to have in a traditional business environment, but there are things which will help make potentially distressing and difficult conversations in the workplace more empathetic, more productive and maximise the opportunity for better outcomes. And bad news can be anything from a poor performance review\/disciplinary to losing an important customer or redundancy. What\u2019s OK news for you might be bad news for them; a friend of mine left her senior position in a company because she was told she couldn\u2019t take a holiday when she wanted to!<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Here\u2019s a brief look at some simple steps that will help level the aeroplane.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Check-in and Credibility<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Ideally, a difficult conversation should be conducted face-to-face, whenever possible, in a private setting.\u00a0 Try to build in more time than you think might be necessary. <a href=\"https:\/\/dev.twentytwo.digital\/ukbodytalk\/resources\/blogs\/virtual-communication-skills\/\">If it\u2019s on a virtual call, be well lit<\/a> (otherwise our emotional mind will find reasons to justify you as the \u2018shady\u2019 figure you present) and make sure your microphone works well.\u00a0 <a href=\"https:\/\/dev.twentytwo.digital\/ukbodytalk\/resources\/blogs\/what-to-have-in-your-virtual-background\/\">Have a background that reflects the mood of the conversation<\/a>. If it\u2019s redundancies we\u2019re talking about, a Malibu apartment virtual background or one of a beach won\u2019t do the job.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Make it clear what the context of the situation is and check their understanding of why they are there; this will help you present the actual news effectively. Rumours and misconceptions can all feed into how the news is taken; if we\u2019re looking for a positive process moving forward, we don\u2019t want to be the villain in the piece (don\u2019t shoot the messenger is a phrase that comes to mind). Therefore, be clear about your role in the discussion, demonstrate that you are there to help and find out what their understanding is of the situation.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Deliver the News<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">This is known as \u2018the warning shot\u2019 in the medical world. \u00a0\u00a0Be clear and honest about what that bad news is, then\u2026BE SILENT.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">At this point, the other person has \u2018lost control of the plane\u2019 \u2013 anxiety, denial, inability to listen. So, give them time to process.\u00a0I appreciate that, depending on the severity of the news, there might be legal considerations to consider, but if not, I would hold off for the time being. Give them the silence they need. If necessary, count to 10 slowly before you say anything else. \u00a0The balance of empathy you then show is quite nuanced; in the medical world, over-empathetic communication done badly is off-putting (too much \u2018you must feel awful\u2019 talk)  and the patient gives up hope\/it exacerbates despair. What we want is to hand back some sense of control to them even if the situation is something that can\u2019t be changed; we can \u2018umbrella that\u2019 \u2013 for example \u2018given that this is definitely going to happen, let\u2019s talk through anything you want to discuss and see how we can help during the process\u2019.\u00a0 Simple open questions are the way forward here, using open body language (palms up, good eye contact). Empathise with what they are feeling and LISTEN to what they have to say.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">A Clear Course of Action<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">There is a danger that any suggested way forward will sound confusing; remember, the other person is processing lots of things at this time.\u00a0When I was working with a nurse talking about self-administered subcutaneous infusions for patients, she said, \u2018there is a limit to the amount of information they can take in\u2019 \u2013 often they\u2019ve been told the news minutes before they are taken into another room and told how to self-medicate.\u00a0\u00a0 She said the information was potentially baffling, so we broke it down into bigger, simpler steps (there\u2019s a reason why there are three bears chasing Goldilocks, three Billy Goats Gruff and three Little Pigs, and we all love a trilogy \u2013 it\u2019s simple and manageable). Her three steps were \u2018Firstly, how the pump works, secondly, site application, thirdly, any immediate side effects. She was able to walk them through this calmly, adding in the necessary detail to each step.\u00a0 And summarise back at the end. Remember, in the moments after receiving bad news, we literally can\u2019t hear, so anything to make it easier.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Continue to clarify to find out their thoughts as you go through the suggested course of action.\u00a0 At this point, there is a temptation (that we may be completely unaware of) to talk and not listen or make assumptions. Use simple questions that reflect back what you have just heard.\u00a0 For example if someone says \u2018I\u2019m angry\u2019 don\u2019t assume you know the reason why they are angry; often repeating back the key emotional words you are hearing are the key to finding out really what\u2019s going in and that will help with the relationship afterwards.\u00a0 \u2018TED\u2019 questions &#8211;\u00a0 \u2018tell me more\u2019 \u2018explain that in more detail\u2019 or \u2018describe that for me\u2019 will illicit more (and more) useful information than \u2018where, what, who, how\u2019, which are great questions but will give you limited information.\u00a0 And finally\u2026 avoid the question \u2018Why\u2019.\u00a0 \u2018WHY???\u2019 I hear you ask, and immediately I feel judged!\u00a0 Replace \u2018why\u2019 with \u2018in what way\u2019 or \u2018tell me more\u2019 as this will help keep rapport.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Three simple steps (see what I did there?). Right\u2026 I\u2019m off. I\u2019m getting the train to speak to the Oncologists. Wish me luck.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n","protected":false},"excerpt":{"rendered":"<p>I\u2019m hosting a masterclass later today for Consultant Oncologists on delivering and discussing \u2018bad news\u2019 with patients.&nbsp; When asked, I was hesitant; I mean, these amazing professionals have to deal with difficult conversations on a daily basis and as a communication skills lead, I\u2019m stepping into territory that could potentially patronise and offend. &nbsp;Subsequent conversations [&hellip;]<\/p>\n","protected":false},"author":15,"featured_media":4093,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"content-type":"","footnotes":""},"categories":[1,16],"tags":[],"class_list":["post-4089","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-general","category-blogs"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v25.6 - 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