Current Topic:
Breaking bad news – whose responsibility is it?
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Abstract
A cancer diagnosis is the most feared disease by society today as it is a life or death situation. It can cause stress and anxiety, affecting the patients’ physical and psychological well being and is the diagnosis that most symbolises death (Morton, 1996). Doctors and nurses traditionally report having difficulty in delivering a cancer diagnosis to the patient. Although it may be the doctors’ legal responsibility to inform the patient of the diagnosis and available treatment options, patients are very likely to require support following the bad news consultation. This module looks at who breaks bad news in cancer care and the role of nurses in this context.
The impact of a cancer diagnosis is individual, and can produce stress and anxiety in the recipient. Clarke et al (2002) considers the impact of a cancer diagnosis may affect patients. In essence, a person faced with an initial diagnosis of cancer is violated by an invading pathology that can not be quelled by any measure of self or inner resource. Frequently when a patient receives a cancer diagnosis, it is usually given by a doctor in a hospital setting who may have had little experience or training in giving bad news.
This module uses a UK study looking at who breaks bad news to illustrate some of the issues raised when breaking bad news. While the findings from this study suggest that the consultant is the person who predominantly delivers a cancer diagnosis and discusses treatment options with patients, the literature suggests that nurses are considered to be best placed to participate in these consultations. Training in breaking bad news is essential to encourage and enhance the ability to participate in, or undertake the difficult task of delivering a cancer diagnosis. Health professionals working predominantly in the specialist oncology setting are more confident in breaking bad news and in particular, nurses with many years of cancer experience.
Morton R. (1996) Breaking bad news to patients with cancer. Professional Nurse. 11 10 669-671
Clarke D. Flanagan J. Kendrick K. (2002) Advanced nursing practice in cancer and palliative care, Palgrave Macmillan, New York.
