Breaking Bad News

  • You will need to use your judgement how long to stay — and how long the family wants you to be there. It may be for a longer period. Or it may be that after they have heard the main details, they wish to be left alone for a while, and for you to come back later.
  • At an appropriate point once you have delivered the bad news, discuss how long you are able to stay. Agreeing that you will stay for another hour, for example, will set a timeframe for the rest of the meeting, which you can refer back to as you come to the end of that time.
  • An hour to an hour-and-a-half has a natural progression. Very often, most of what needs to be said/discussed can be done in that time, as long as all present know that that is the time that is available.
  • Remember when considering how long to stay that even an hour is a long time to spend with people in a highly emotional state.
  • As that time approaches, refer to the amount of time left. This will help you to end the meeting as agreed.
  • Some phrases that might be useful:
    • "We have talked about a lot of difficult/painful things here. You may find yourself going over these in your mind."
    • "Writing your questions down may help, and we will try to answer them the next time we meet or telephone.
  • Sometimes the meeting will develop its own powerful family dynamic, and you will realise that it is better for you at this point to leave. Words might include.
    • "Perhaps we should leave it at that now?"
    • "Perhaps we have gone as far as we can at the moment, and we'll have to leave it there for now."
    • "We will be meeting again on .. and perhaps we can revisit that then?"
  • You might ask the family what would they would like to do. "How do you want to go from here?"
  • Before you leave, arrange with the family very clearly when and how you will next be in touch or meeting. Write down the date and time of your next meeting for the family to remember. Make sure you keep that appointment. It matters crucially for the family.
  • If there is still much to say that you have been unable to communicate, then perhaps you should arrange to go back the next day. If you have given all the information you have at this point, and are waiting for other details, then make arrangements to see them in a couple of days.