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learning zone assessment
READER’S PRACTICE PROFILE
Communicating bad news
Eleanor Carter-Brown is better prepared to convey
bad news to patients after reading a learning zone article
The article redefined my idea
of ‘bad news’, which I had
previously considered to be
about life expectancy or quality
of life. However, Kaye (1996)
defined bad news as any news
that alters a patient’s view
for the worse.
Difficult conversations may
include informing a patient of
a delay in, or cancellation of, his
or her treatment and discussion
regarding long-term care.
The author’s ten-stage
strategy promotes the
importance of ‘protected time’
to avoid interruptions when
communicating bad news.
I also appreciated the practical
suggestion about giving the
patient a warning sign. Effective
communication of bad news
involves treating patients as
individuals by listening,
discussing, empathising and
being supportive.
Gibbs’s (1988) reflective
model is a simple, effective
step-by-step guide to reflection
NURSING STANDARD
to provide any advice about
distancing oneself from the
work environment. Perhaps it
should be added as an eleventh
stage to the ten-stage strategy.
However, this omission has
encouraged me to do some
personal research. Discussing
the subject with other students
and healthcare staff is a
practical start and literature on
caring for dying patients is a
useful source of advice and
information.
Personal development
All nursing students should read
CHARLES MILLIGAN
this article. Communication
skills are essential to the nursing
role and reflective practice is
necessary for professional and
personal development.
Communicating bad
news requires preparation.
The ten-stage strategy helps
in treating patients as
individuals. Preparation and
establishing what patients
that I would recommend to This practice want to know means that their
others. Group reflection is profile is based needs are being assessed on an
on NS487
something I would like to individual basis.
McGuigan D
implement because it can (2009) I now feel more confident
improve insight and Communicating about communicating bad
understanding of complex bad news to news to those in my care. By
professional issues. I have patients: a reflecting on these situations
reflective
already felt the benefits of the approach.
when they arise, I can improve
reflective exercises I have Nursing Standard. my communication skills and
completed and my work has 23, 31, 51-56. the care I provide NS
improved as a result. References
The article briefly discusses Gibbs G (1988) Learning by Doing:
the effects on nurses of A Guide to Teaching and Learning
communicating bad news. Methods. Oxford Polytechnic, Oxford.
Eleanor
The stress and distress this Carter-Brown, Kaye P (1996) Breaking Bad News: A
can cause to the nurse is nursing student, Ten Step Approach. EPL Publications,
significant, but the article failed Worcestershire Northampton.
Write your own practice profile
You can gain a certificate of learning by reading a Nursing Standard learning zone
article and writing a practice profile. Turn to page 50 for this week’s article and on
page 60 you can find out how to present and submit your practice profile.
Visit the RCN Learning Zone
The RCN Learning Zone is a FREE online service to help RCN members
with their continuing professional development and professional portfolio
management. The RCN Learning Zone is available at
www.rcn.org.uk/members/learningzone.php
june 9 :: vol 24 no 40 :: 2010 59