Nurses deliver difficult news every day. Whether it’s reiterating exam results the physician explained earlier to the patient and now the family that was absent is suddenly present and the patient no longer remembers all the intricacies of the delicate conversation or simply informing a patient who has been NPO all day that, yes, another procedure was just ordered requiring NPO status for a little while longer, sharing not-so-great news is a part of work.
Nurse managers and leaders, while many still (unfortunately) wrongly think “sit behind a desk all day,” are not immune to delivering difficult news. The news simply changes. It may range from disclosing medication errors with patients, families, and internal team members to letting a team member go giving someone the opportunity to excel at another organization to telling a physician or social worker or administrator why his specific pet-project doesn’t fit into site/network/unit/daily priorities right now.
Whether in health care or not, we all must share difficult news with others at some point. It’s rarely a skill (yes, skill) we are trained to do or encouraged to refine through ongoing education and practice. Yet, when the time comes to actually deliver the news, it is easy to notice inadequacies. Here are a few things I do when sharing especially difficult information with others.
1. Prepare. This is a loaded step involving data gathering, thought refining, and word selection. Be sure to gather information you can use when sharing difficult information with others. You should cover the basics, explaining the issue as fully as possible or allowed. People typically have questions, and you need to be prepared to answer them honestly and openly with the information you’ve acquired. Separate the facts from opinions, which may be your own biased views, as well. In conjunction with having the correct information, you need to prepare your thoughts and words. If you can practice saying the news out loud, that is helpful to allow you to hear what you’re actually thinking, which often sounds very differently from what you’re meaning to say.
2. Share in person. The more sensitive the information, the more personal the conversation needs to be. An email firing someone is not appropriate. A telephone call relaying bad news, while it occurs often, is not ideal. Body language and tone relay volumes of information. If it truly is difficult news, say it to people in their presence, with eye contact.
3. Allow questions. Difficult news creates a disruptive state. Encourage questions so people can have all the information (that you’ve either already gathered or will find out if you do not know the answer). When people have their questions answered, everyone can work with the same knowledge and rumors can be laid to rest.
4. Provide feedback. If the difficult news is part of a “process,” be sure to provide regular updates to everyone involved.
Do you see a theme here with information and transparency? As with everything, these tips typically take practice. Good communication is a skill. You may have to intentionally think about these tips the first few times you share difficult news; with practice, though, these become second nature.
How do you prepare to share bad or difficult news with others?
