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I have had experience with this, especially cause I work at the hospital a close friend was working with my mother in law and she found it much more emotional burden because her relationship with me was close, she didn't want to switch patients because she wanted to give best care. 

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I have had experience with this, especially cause I work at the hospital a close friend was working with my mother in law and she found it much more emotional burden because her relationship with me was close, she didn't want to switch patients because she wanted to give best care. 

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Would be a good idea for Julie to talk to her specialist nurse to get some clarity and support.

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Overwhelming, anxious, needs more support to make her feel more at ease with making her decision. Needs psychosocial support, does she have support at home? Getting different teams involved such as pain team

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So much information to process and deal with. Lifechanging surgery.

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Has anyone considered how all this bad news is affecting her

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Seems she has no support around and could do with talking and engaging in some cancer groups to relate to other people

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It feels like all the health care professionals are busy treating the symptoms and the cancer but not the holistic care needs of the patient, family support, conversations about new normal afterwards ect

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It feels like all the health care professionals are busy treating the symptoms and the cancer but not the holistic care needs of the patient, family support, conversations about new normal afterwards ect

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She will be depressed about the whole issue and confused on what the out cone might be

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She will be depressed about the whole issue and confused on what the out cone might be

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Harsh reality of the system doesn’t make it easier 

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Harsh reality of the system doesn’t make it easier 

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This sounds like a thorough process, multiple appointments and tests, but it is the reality, practitioner reality, but that is not the patients reality and doesn’t make it easy

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It is a lot to go through with minimal support

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Breaking bad news in Julies case, was definetley a process

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Breaking bad news in Julies case, was definetley a process

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She has had a lot of bad news

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Sounds like Julie has had a tough time

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Julie Jones is a 58-year-old woman with colorectal cancer. She has recently

developed widespread liver metastases and was told earlier in the day at an

outpatient appointment that the cancer is no longer responding to her current

treatment. The consultant and nurse specialist have outlined the different

treatment options available and Julie has a return appointment the following

week to talk through her decision. Later that evening, Julie is thinking back to

all the times when she has heard bad news since she developed cancer. To get

things clear in her head she notes them down on a piece of paper, as follows:

1) Going to see the GP when I had symptoms and being told I would get an

urgent appointment in two weeks to see the specialist. I knew then it was

potentially serious and it could be cancer.

2) Being told by the hospital doctor that the tests showed it was cancer and

I needed surgery.

3) When the nurse specialist explained to me what the surgery would

involve, especially finding out about the stoma.

4) Attending the preoperative assessment clinic and hearing about the

details of the operation and hospital stay, especially the anaesthetic and the

risk of developing blood clots.

5) Being admitted to the ward and finding out that visiting hours were

restricted so my daughter could be with me for only a few hours a day.

6) Being marked for the stoma site – this really brought home what I was

having done.

7) Seeing my stoma for the first time and being taught how to keep it clean

and put on the bags.

8) Finding out I would need to have chemotherapy at the cancer centre.

9) Having the treatment explained to me by the doctor and then the nurse

at the cancer centre – the months and months of treatment, the scary side

effects, all of the things I had to look out for and remember to do.

10) Being informed that I had neutropenic sepsis and had to stay in hospital

for intravenous antibiotics.

11) Hearing that I needed to go for more scans when I told the doctor about

the new pain in my side.

12) My nurse specialist explaining to me why the scans were being done and

what they might show.

13) Learning that I had liver metastases and that the chemotherapy I am on

at the moment is not working.

14) Listening to the different treatment options earlier on today – how on

earth am I going to decide what to do

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Emergency situations trama of the event you don’t have time to process & you carry on delivering care to the unwell patients

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No after care support

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Brings comfort

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Allowing family time with the patient towards the end

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Packages of hearts, resources and information given.

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Doctor refused to explain to the children of a patient what was happening because “they’re too young to understand anything”. They were all between the ages of 18 to 25.

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Family shocked when told nothing more can be done because of poor communication all along.

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Family room used

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Age if younger than you can be harder to deliver

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Don’t with no care or compassion

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Support throughout for all and clear answers

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Comforted the family after death, brought cups of tea and coffee.

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Bad communication

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Some doctors think that the bedside curtain means no one else can hear

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Poor communication between hospital and community 

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Poor communication between hospital and community 

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Convos took place in private (side room and day room with no other families / staff there)

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Age dismissed in the sense of “they had a good life” attitude

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Very medical, not personal

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Patient was paliative, had major surgery and family had hidden that she was dieing. Was admitted due to pain management, family had written a letter for staff stating it was for best interests of patient that she didn't know. Patient had full capacity 

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Patient was paliative, had major surgery and family had hidden that she was dieing. Was admitted due to pain management, family had written a letter for staff stating it was for best interests of patient that she didn't know. Patient had full capacity 

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Patient had to ask me after the doctor had left what he had said because they didn’t understand any of the medical jargon used.

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Being honest and giving advanced warning/preparing the family.

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Good communication (nonverbal and verbal)

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Time spent thinking on how to break the news

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Was direct and clear answered questions well and made sure the patient understood

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Family given clear information, EOL packs, reassured and comforted

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Very emotional

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Quality communication

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We’re keeping her comfortable- what does that really mean?
What it meant was she was end of life. If I hadn’t have called to ask what that meant then my family would have continued to think she was ok and still being discharged

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After care from the nurses and HCA offering tea to families etc

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Done by drs in inappropriate area

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Family were not aware patient was on EOL care

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Compassion was given, time was spent with patient asked if they wanted family present beforehand

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The Dr had trainee drs with them who were overheard laughing about observing bad news being given by a relative

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The Dr had trainee drs with them who were overheard laughing about observing bad news being given by a relative

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Negative body language

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Nurses collating all notes and documents before to ensure they could deliver the facts

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Not in the appropriate environment. Speaking to family in a bay where others can hear. 

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Not in the appropriate environment. Speaking to family in a bay where others can hear. 

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Family unclear about what was happening

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Poor dr bed side manner

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Was told in the middle of a busy A&E department that family member was critically ill and not sure if they will make it

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Delay in the delivery of the news

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Compassion, kindness and empathy

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Clear cut communication

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Not looking after the relatives comforting them. Just sitting at the station chatting about the weekend

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He’s past away

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Family were given time and room to grieve

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Poor communication, family distressed and not comforted

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Nurse being too over familiar, was uncomfortable.

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Honest

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Stated facts but still was compassionate

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The location. The patient was alone. Lack of support for the patient 

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The location. The patient was alone. Lack of support for the patient 

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Soft tone, sympathetic and allowed time for family to take it in & ask questions

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Soft tone, sympathetic and allowed time for family to take it in & ask questions

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Preparing the family earlier to the event

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Body language and terminology used by the nurse was appropriate for the setting & people involved.

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Body language and terminology used by the nurse was appropriate for the setting & people involved.

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Telling someone they had breast cancer in the middle of the waiting room in breast clinic whilst the patient was alone but waiting with other patients.

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Unsure if necessarily bad, but nurse waiting for confirmation from doctor to tell family pt had died, ‘keeping’ truth from family

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Reassured patient and family

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I managed to break the news and received well

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The doctor was not being clear and concise and “beating around the bush” - the nurse had to take over the call.

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On my last placement a patient had passed away on the evening, body moved etc. family turn up to visit the next day and hadn’t been told

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“Yep, good chance she’s dead”

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It was done well and very professional while also being empathetic and sympathetic to me and my family. The Dr explained it for my family but knows me so apologised for putting me through it 

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It was done well and very professional while also being empathetic and sympathetic to me and my family. The Dr explained it for my family but knows me so apologised for putting me through it 

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A private area used with good communication and family given choice and time.

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Informative with the news was sharing

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Keeping family up to date on any health changes, so that they understand how critical the patients health is

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Was delivered with compassion

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Taken into a quiet area, spoken with myself and a doctor, all questions answered and offered any comforts

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Explained what happened in lead up to event, before breaking bad news

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Not very clear about the bad news spoke around the subject didn’t explain this in a way the patient understood. Left patient feeling very confused and upset

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Clear and informative information give to family

Gave the family time to process information

Reassurance give.

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Vascular surgeons bed side manner wasn’t good, came across quite cold and abrupt to the patient and didn’t take the time to explain what and why.