Episode 05: Family Witness Resuscitation and Breaking Bad News with Nick Brown (Part 1)

Health professionals are not usually taught what and how to deliver bad news, despite it being one of the most stressful parts of the job. Each case is different, but in this episode Eoin and Rich discuss the commonalities that it will help to bear in mind when the worst comes to the worst.

There are four stages to the deliverance of bad news:

State your name, profession, and what you’re going to do. (Ex. My name is James, I’m a paramedic, I am going to….) It’s important to do this while you approach the patient to avoid wasting any time. Every second counts.
Politely ask the relatives for some room during attempt of treatment. Let them know that you will update them as time goes on. If appropriate, a relative or friend can come in and stay with the patient. Most of the time the relative would console the patient and hold the patient’s hand.
When updating the patient, it’s important to restate your name. There is a power to saying your name because it gives a sense of calm to the relatives who are waiting to see what is going on.
When updating relatives, it’s important to use simple terms and define certain words if needed or if any confusion is presented. Avoid any difficult medical terms. Remember that the relatives are in a state of shock and confusion. Every word you choose will determine the reaction of the relatives.

Whatever happens, avoid showing your emotions while attempting treatment. The way you look at the patient if any relatives are present may indicate what is going on with the patient. Avoid words: Like, um, I guess, I think” Be concrete.

There is a struggle between clinical and family expectations. Sometimes, there’s is nothing that can be done from a clinical perspective, but the family would want you to continue the attempt to resuscitate the patient.

Regardless of how much practice you have, it’s never an easy to deliver bad news and can be emotional even for the paramedics. Whatever happens, remain professional and allow the family the space to process their shock as they will.