Coronavirus (650) How can I break bad news remotely?

22 May, 2020

This article may be useful for those who are unable to see patients physically during the coronavirus pandemic.

CITATION: How can I break bad news remotely?

BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m1876 (Published 12 May 2020)

Cite this as: BMJ 2020;369:m1876

Covid-19 has made breaking bad news harder than ever. Doctors share their advice on how to speak to patients and their families when you can’t see them face-to-face.

Prepare as if you were meeting in person... Consider having the conversation by videocall, so you can assess and respond to non-verbal cues, and talk to the patient and their significant others concurrently...

“Firstly, prepare by defining the key message of the conversation: centre on your compassion and remember that you speak on behalf of your team. Begin the call by establishing names and identities — yours and the person you are speaking to — and ascertain that they’re in a safe place for a conversation...

“Tone of voice and empathic language are important: bad news is best told in simple, non-ambiguous words. Listening is as important as speaking: allow silences, acknowledge emotions, and reassure that weeping is acceptable.

“Finally, closure is reached by offering to answer further questions, helping the person to plan what they will do next, clarifying arrangements for next steps like when there will be more news or how to collect a death certificate, and always restating empathy."...

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Best wishes, Neil

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HIFA profile: Neil Pakenham-Walsh is coordinator of the HIFA global health campaign (Healthcare Information For All - www.hifa.org ), a global community with 20,000 members in 180 countries, interacting on six global forums in four languages in collaboration with WHO. Twitter: @hifa_org FB: facebook.com/HIFAdotORG neil@hifa.org