Helping Medical Students Communicate with a Terminally Ill Patient or Grieving Family
The title of this article sums it all up, how difficult it is to control your emotions and be able to talk about a severe life-threatening illness or death. As a medical student, you will have to learn the hard way and be able to communicate with patients and relatives, telling them news that will always be hard to bear.
Getting it right
Breaking bad news in any situation is not something that comes naturally to many of us, but the part of medical training that almost no one wants to complete is how to communicate bad news. Reporting a terminal diagnosis or the death of a loved one to a relative is a skill that has to be honed over some time. The critical thing to remember is that people remember correctly how lousy news was conveyed to them; a cancer patient can always tell you the exact moment when they were told about their illness. Hence, the onus is on the medic to get the message across in a concise but compassionate way.
If you have to tell someone about a death or illness, it should always be in a private consulting room and always ask them if they would like anyone else present. That particular question leads a person typically to understand that they are about to hear bad news and, although difficult, is almost always the right way to start the process.
Level of information
If you are dealing with a patient who has a terminal diagnosis, it is often advisable to first establish how much they know about their current condition. Once you have found their level of knowledge, a crucial step is to ask the patient how much they want to be told. People have different ways of dealing with a critical situation. Where one person wants to know every small detail about their condition, others prefer not to hear it all in the first instance, so establishing the level of detail will help on both sides.
Responding to a patients reaction
This is a skill acquired over time, but you have an opportunity to show a caring and compassionate attitude at the point of imparting devastating news, and being able to respond to their reaction in the right way will help the patient deal with the situation. If they ask for time to take in the news, then arrange to give them a short break or to come back later at a time that they feel is right rather than attempting to get the process over with as quickly as possible.
Dealing with a death
In much the same way as you would try to comfort and also advise a patient about their terminal illness, the same skills of tact and compassion apply when telling a relative about the death of their loved one. The news should always be given in private and after you have established if anyone else should be present.