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if you are nervous or feel really bad you may downplay the bad news and then the recipient may not understand how severe it is, it is better to be as honest as you can

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Professional relationship so if the healthcare professional is close to their patient, it might make it more harder and difficult to tell them the bad news and there might be a fear of reaction so the patient might be angry, in denial or sad.

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You may feel emotionally affected yourself

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Remaining serious (as someone who laughs out of nervousness in serious situations)

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Fear of unprepared and difficult questions

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- lack of confidence

- fear of upsetting patient/family

- don't fully understand the medical aspects

- family/patient denial

- time pressure - other patients

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Fear of damaging professional relationship

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Language barriers- if a patient/patients carer is unable to speak English and requires a translator we may struggle to convey that empathy and understanding when breaking bad news

If you have had a stressful shift then it may be hard to show empathy when breaking bad news as you can have other things on your mind/not be present when communicating to the patient

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Language barrier, like the person who you want to break the bad news to, maybe not be able to speak your language.

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using jargon when breaking bad news

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Barriers = Communication barriers, language barriers, geographical barriers …

Fears = Don’t know what to say to comfort them, might be put at blame, lack of concentration to carry on with shift

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Barriers/fears

Language

How will they take the news?

What if I can't answer their questions?

Other family/ friends in the vicinity

Blame

Anger and confusion

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Recipient may be too young to understand the information.

Recipient may have a disability which means that they might not be able to understand the information.

Recipient may not handle the information well, and may react with anger or distress.

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Some people may not be able to take bad news well and will refuse to believe it.

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Bad reaction to passing on news, fear of people becoming violent or angry, if someone doesn't understand English properly, has a hearing difficulty (something affecting their level of understanding). someone with learning disabilities may struggle to understand or cope with the bad news. Using medical terminology can scare a patient making them assume something is worse than what it is.

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Something that may be a 5-10 minute conversation out of our shift could be a life changing piece of information to the recipient and if we’ve had a stressful or busy shift its harder to be as focused on that conversation as the person would want as it could have a big effect on their life

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Time restricted - not having the time to go through it properly and answer any questions or in a rushed/emergency situation where a life or death decision is to be made.

Sounding like a robot

Children may not grasp what your trying to tell them but this depends on their level of understanding.

If they have known anger issues then the HCP may be more anxious

HCP feelings about the situation - if it is a patient they really liked or got a connection with.

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Lanauge barriers, facial expressions, proximity, worrying how they will react and worrying Ill start crying

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Being blamed for the circumstance

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Fear of the other persons reaction. You don’t know how’ll they will react

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not being able to sound genuine or empathetic, sounding forced

you don't know how the other person will take the news