"Breaking bad news is all about empathy with the person you are speaking to"

Why breaking bad news can be a difficult yet important task for doctors.

by Dr Su Laurent MBBS FRCPCH, Child Bereavement UK's Medical Advisor

Delivering bad news is one of the hardest things you ever have to do as a doctor. As medical students, we do a lot of training around giving bad news; while it pales into insignificance compared to the impact it has on patients, it’s only when you’re in that situation that you realise the impact it has on you. It is one of the things that affects us most profoundly as doctors and one of the things that we dread most.

No matter how experienced you are as a doctor, you know that the conversation is likely to be hard. As you gain experience you gain a few more tools - you are better at pacing things and more aware of the choices available to a family - but that anxiety never completely goes away.

Breaking bad news is all about empathy with the person you are speaking to and thinking about how you would like things to be explained.

Breaking bad news is all about empathy with the person you are speaking to and thinking about how you would like things to be explained. It is about sitting with a family and allowing time for the news that you give to be digested.

Kindness not only towards the family and colleagues but also towards ourselves is central. There are situations where, as doctors, we may feel really at one with a family, for instance if we have a similar aged child, and it can profoundly affect us. I remember not long after coming back from maternity leave having had my first child, a baby tragically died in our emergency department. I was devastated for the parents, feeling at one with them and the impact of their loss; I needed to be professional and yet felt very tearful.

Doctors and nurses sometimes say to me, ‘I was very unprofessional. I found myself choking up and I tried to hide it,’ and I always reply, ‘I’ve never yet met a family who is upset by a member of the staff crying with them, but you don’t want them to have to comfort you and you still have to be there for them, they’re not there for you.”

It can really help to be aware of what might be going on for other team members so that you can support one another and, where possible, relieve a colleague if a situation is particularly difficult for them. I always recommend that whoever is leading should gather the team together and give them even just a ten-minute space for a cup of tea.

Above all, we should be kind - whether that’s to children, parents or colleagues and treat everyone as we would want our own family to be treated.

There is no doubt that breaking news to parents that their child is not expected to live and supporting them through this devastating time, are difficult things to do. Yet if we work closely with parents during this time, it can also be rewarding. As a doctor you can give a sense of control to parents who may have been fighting for their child, fighting to be heard and fighting for things to happen. Above all, we should be kind - whether that’s to children, parents or colleagues and treat everyone as we would want our own family to be treated.

For guidance for doctors supporting families when a child is not expected to live, watch this short film with Dr Su Laurent, Child Bereavement UK's Medical Advisor made with funding from BMA Giving.

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