Arguably one of the most difficult parts of being a nurse is delivering bad news to patients and their families.

Whether you’re informing a patient of an unfavorable diagnosis or telling someone their loved one has passed away, the situation is emotionally draining and one nurses dread.

To help make the task a little easier, here are a few tips for breaking bad news.

• DO... Prepare for the conversation. Find a quiet, private room where there will be limited interruptions. Determine who should be present (for example, whetherfamily members或者应该包括朋友）。告知那些相关人员，他们将收到严重的信息。安排足够的时间来传达新闻，并让患者和家人提出问题。
• DO...注意您的肢体语言和语气。尽管您可能会感到紧张或痛苦，但您有责任保留并得到支持。
• DON’T… Assume you know what the patient or the family wants to hear. Some may want as much detail as possible while some prefer to learn just the basics. Ask open-ended questions such as:

- 您对我告诉您的内容有什么问题？

- Can you tell me more about what you are thinking or how you are feeling?

- What other information do you feel you need at the moment?

• DO...要100％诚实，不要为新闻的任何部分加糖。提供inaccurate informationnot only gives the patient and family false hope, but it can also have legal consequences if the promised outcome is not the actual outcome.
• DON'T... Use medical jargon. Assess the patient and family’s level of familiarity with clinical terms to ensure they fully comprehend what they’re being told.
• DO... Deliver news one piece at a time and don't move onto the next until you're sure the patient and the family understand. Don’t accept silence as recognition or acceptance.
• DO… Repeat important information if necessary. The patient or family may not have fully processed what they heard the first time you said it.
• DO... Actively listen and show empathy. Demonstrate that you recognize the gravity of the situation and let the patient and family express themselves however they prefer.
• DO...为悲伤的阶段做准备。每个人都以自己的方式对坏消息做出反应。您的病人或亲人可能会在几分钟之内迅速从拒绝到愤怒到讨价还价，而家庭的其他成员可能会在第一阶段持续几天。在解决每个人时考虑到这一点。
• DO...让家庭有时间在进行有关下一步或治疗计划的细节之前消化信息。
• DO... Discuss the future. Let the patient and family know the immediate next steps and long-term plan for treatment. Offer resources and connect them with support services.

Delivering bad news will always be challenging, and, unfortunately, there will be times where you will be unable to thoroughly prepare. The best strategy is to practice with colleagues so you feel more comfortable when the situation arises. Remember that although you are in a difficult position, you have an opportunity to成为病人的岩石和他或她的家人最脆弱。您如何支持他们会对他们的经验产生重大影响，并可能使他们的生活变得更加容易。

为了在住院期间为每个患者提供最佳体验，护士应采用以患者为中心的护理。下载免费电子书，How Nurses Can Increase Satisfaction through Patient-Centered Care, to learn more.