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There is no good way to give bad news!
When a diagnosis has been finally arrived at the health professional has to confront the person and provide answers. For both, the health professional and the person, it is a very stressful and delicate moment during which the health professional has to impart difficult and upsetting news.
The person may already be in a state of anxiety, aware but unsure that there may be a very serious problem or how serious the problem is that is confronting them. They will already feel trepidation brought on by the various diagnostic tests, consultations, hospital visits they have already undertaken.
Not every person is going to have explained to them that the risk of them dying is very high, however many life long diseases / disorders, such as MS, ME, and the problems they present, the impact it will have on that persons life may cause them to consider that a death sentence has been pronounced.
Some considerable time can elapse between an initial consultation and when a diagnosis is confirmed. This time lapse will contribute to a persons fears and may create feelings of frustration and anger, not only within the individual but amongst their family and friends.
Early diagnosis is essential, the longer the wait the greater the danger. Disease / disorder progression waits for nobody. A considerable number of GP’s [1] have very little contact with those who are suffering from a serious disease / disorder, therefore their symptoms and what they indicate may not be immediately apparent to them. Early diagnosis could not only prevent significant and lifelong health problems but may prevent some disease / disorders worsening.
Once diagnosed a sufferer needs constructive information on an immediate basis, this will enable them to not only understand the disease, but how to confront it.
There is no easy way to give bad news, but there can be less bad ways!
The health professional is confronted with a series of questions to think through.
- Does the person have any knowledge about the disease / disorder they are being confronted with?
- How can the person and family be helped to confront reality in a gentle and sympathetic manner?
- How does health professional assess what that person really wants to know?
- Will the person be able to understand the diagnosis?
- Will the person experience shock and not understand what is being explained to them?
- Will the person become angry? -
frustration may occur when it has taken some while for a diagnosis to be confirmed. Often suffers are not taken seriously - Will the person develop or already have a state of denial?
It is natural for anybody to want to be seen as an individual, a normal decent human being, not just a case number. Bad news presented to anybody in a cold factual manner is extremely distressing, crushing a person’s hope. Such an impersonal arrogant bullying manner causes the person to consider that the health professional view them as an item rather than a human being and by so doing doesn’t care.
People go to a health professional seeking an answer for a health problem, when matters become serious they can become frightened, apprehensive and defensive. Confronted with what may appear to be an attitude of indifference the person can become despondent, depressed, lose hope leading to an attitude of indifference causing them to adopt an attitude of ‘what’s the use’ and becoming less than diligent in taking medication they may need or adopting a healthy lifestyle regime that would benefit them.
Being a good communicator is a skill and some are better at it than others, but it is a skill that can be learnt and may go some way in helping those who have to be told bad news.
Notes
‘Any disease / disorder is very difficult to come to terms with and everything that once felt certain in your life suddenly becomes terribly uncertain’
GP -