When You Get Bad News from the Doctor
It’s not an uncommon situation unfortunately, but it is one you have dreaded as a caregiver. It’s when the doctor has to tell you and your loved one some bad news about the patient’s condition, test results, or diagnosis. This is an important time, and it’s worth some thought and preparation.
If you believe that your next doctor’s appointment might bring you and the patient some important, negative news from the physician, there are some ways to prepare yourself and the loved one.
- First, be prepared to accompany the patient in person. You might bring another family member if they would be supportive at that time. Allow extra time for the appointment; schedule the day so you won’t have to rush anywhere. Turn off the cell phone so you can concentrate on the patient and the doctor.
- Bring along a tape recorder, or pen and paper. You may need to make important notes.
- You doctor will probably start with a few key points and the prognosis of the condition. Realize that you and the patient are not ready for every detail; concentrate on getting just the important parts of information that the doctor shares with you.
- Check with the patient to make sure that he or she understands what is being said. Use language that the patient will understand. Ask the doctor to explain again if the terms are unfamiliar or confusing. Don’t jump to conclusions or let the patient do so.
- Offer empathy and support. It is okay to cry, and it is okay for the patient to cry. The doctor and staff will probably be gentle, supportive and comforting to you.
- Ask what the doctor recommends doing next. It might be to visit a specialist, to get a referral for another doctor yourself, or to go to a hospital or treatment clinic immediately. Find out what to do next and how soon to do so.
- Request information about the disease and treatments in writing. Ask for referrals to specialists with phone numbers and addresses written out. The nurse or staff members can help with this. Obtain contact lists of resources such as Web sites, support groups, or social workers. Keep this information and read it later.
- Call the nurse at the doctor’s office one or two days later to clarify any details, and answer questions that will come up later. Again, check your understanding of what the doctor said to you. In the emotion of the moment, it is likely you will not remember it all accurately
Talk it Over with the Patient
- Make time to discuss what you have heard today with the loved one. Ask her who else should be told about this information. Do not intentionally alarm others or underestimate the seriousness of the condition, and do not deny what is real either. Use words that are accurate and words that convey what the patient is feeling emotionally when you talk with others about the situation.
- Talk over the advice of the doctor, and get started with the actions he recommended. It is acceptable to get a second opinion on the patient’s condition; a doctor will not be offended by this.
- Keep the lines of communication and support open between you and the patient. Open yourself to help and emotional support from family, friends and others.
As a caregiver you will certainly have bad days, and a day such as this will be one of the toughest. However, you have support, from family, friends, neighbors, and health and community resources.
You may be surprised at the strength and love you find around you.
“Delivering bad news: Helping your patients retain dire details.” by Heide Aungst. Staff Editor: Martha Raymond, RN, BSN, BS. http://www.modernmedicine.com/. Oct. 01, 2009.