Tuesday, January 24, 2012
BREAKING BAD NEWS
One thing we weren't taught in medical school (or maybe I was absent at that particular lecture), is how to break bad news.
When a patient who we have been managing dies, we are placed with the unsavoury responsibility of informing the relatives. This is never an easy task because you never know just how they will react.
We've been told the five stages of grief are denial, anger, bargaining, depression and acceptance. However, knowing that theory doesn't make the job any easier. Personally, I've observed the following responses over time.
1. Those that break down completely.
2. Those that ask you to still try to revive the obviously dead person.
3. The practical ones. 'So Doctor ,what do we do next?'
4. Those that are in shock and require you to repeat what you just said.
5. Those that fall to the ground.
6. Those that immediately start calling relatives on the phone.
7. The controlled emotional. It takes a while to sink in, they initially have no reaction.
8. Those that seem relieved.
9. Thankfully have never met those that accuse you of causing the death.
My personal style?
I usually select a relative I feel can best handle the news; who can help inform the other relatives in a calm manner, (and who I hope will not pick me up and throw me across the room or give me a body slam for that matter.) I then give a brief rundown of events that led to the eventual death. I also avoid using statements like ' he is dead', rather I find it more calming to say ' he has stopped breathing.'
Then I wait for the drama.
What has been your own experience on either side?