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News
Objectives:
Students will:
BAD NEWS
DEFINITION OF BAD NEWS
Bad News
Buckman R. BMJ1984
Bad News
Social factors
Physician factors
Two meanings
“I’m sorry for you”
“I’m sorry I did this”
Easily misinterpreted
Why is this Difficult?
NEVER “assume”
If you need to know something
If you want to know something
If you need to know something
If you want to know something
ASK!!
THINGS GO WRONG WHEN:
* WE TRY TO ESCAPE
* WE REACT IN ANGER
• INAPPROPRIATE DELEGATION
• DISTRACTION
• FRONTAL ATTACK
• INTELLECTUALIZATION
• MINIMIZATION
• EMPTY REASSURANCE
THINGS GO WRONG WHEN:
WE REACT IN ANGER:
• TO DENIAL
• TO IDEALIZATION
• TO REHEARSAL OF THE STORY
• TO ‘UNREASONABLE’ DEMANDS
• TO ANGER AND BLAME
THINGS GO WRONG WHEN:
• BILLING
• PRACTICAL ARRANGEMENTS
Tolerate silences
Ask!!
Do not allow families to run
interference
Acknowledge emotions
strong emotions prevent
communication
identify and acknowledge them