Breaking bad news to patients is a sad yet unavoidable duty of medical professionals. Is revealing a terminal diagnosis and explaining the situation a part of doctor’s duties or not? Should nurses take part in the process? There are no clear-cut answers to these questions, and before students can make conclusions of their own, it is beneficial to get acquainted with a sample of writing on the topic. This nursing research paper example will let you know the ropes and help you with researching this delicate topic on your own.
Research shows that most doctors and nursing specialists are extremely reluctant to announce and discuss terminal diagnoses with patients and their families. The reasons for this are numerous.
Medical specialists don’t want to deprive their patients of hope. They don’t like to deal with emotional repercussions of the announcement. In addition to that, discussing such a topic requires immense skills of interpersonal communication, which are usually not considered to be a part of a traditional doctor’s skill set.
In this view, it may seem that nurses, as people dealing with patients on a more personal level, should be the ones responsible for breaking the bad news. However, most examples of polls concerning this question show that majority of nurses believe that it should be doctors’ responsibility. Nevertheless, they admit that nursing personnel plays an important role in this situation and, therefore, should be trained in communication skills and taught how to behave when encountering the need to break news to a terminally ill patient.
Another point liberally researched in a number of papers on the topic is the question of whether the patient should be informed about the terminal diagnosis at all, and if yes, at what point. There is, for example, a point of view that suggests that concealing the information of this kind from the patient can help him avoid additional emotional suffering. However, absolute majority of those taking part in polls believe that it is patient’s right to know (82% of patients and 83% of doctors treating them are in favor of disclosing a terminal diagnosis).
The attitude to disclosing the information to the patient differs from culture to culture. In Western world, doctors are much less likely to withhold information about his condition from the patient at his family’s request, as noted in the paper by Baile et al. In less individualistic cultures, this may not be the case: for example, in the Middle East, patients are not autonomous and doctors have to deal primarily not with them but with their families, and the decision concerning declaring diagnoses usually lies with the family as well. Nevertheless, the general attitude remains the same: most people would prefer to know the truth in case they are diagnosed with cancer or a similarly serious condition.
When all is said and done, the conclusion one has to make is that disclosing bad news is a responsibility of the entire medical personnel working with the patient. Doctors may be the ones best suited to make the announcement per se, but nurses should work in tandem with them to alleviate the pain it causes and make sure patients and their families understand the situation clearly.
References
- Baile W., Lenzi R., Parker P., Buckman R., Cohen L. (2002). Oncologists’ attitudes toward and practices in giving bad news: an exploratory study. Clinical Oncology, 20(8), 2189-96.
- Doumit M., Huijer H., Kelley J., El Saghir N., Nassar N. (2010). Coping with breast cancer: a phenomenological study. Cancer Nursing, 33, E33–9.
- Friedrichsen M., Lindholm A., Milberg A. (2011). Experiences of truth disclosure in terminally ill cancer patients in palliative home care. Palliative Support Care, 9, 173–80.
- Shaw J., Dunn S., Heinrich P. (2012) Managing the delivery of bad news: an in-depth analysis of doctors’ delivery style. Patient Education Counsel, 87(2), 186–92
- Tobin G., Begley C. (2008) Receiving bad news. A phenomenological exploration of the lived experience of receiving a cancer diagnosis. Cancer Nursing, 31(5), 31–9.
- Tsoussis S., Papadogiorgaki M., Markodimitraki E., et al. (2013). Disclosure of cancer diagnosis: the Greek experience. J BUON, 18, 516–26.
- Warnock C., Tod A., Foster J., Soreny C. (2010) Breaking bad news in inpatient clinical setting: role of the nurse. J Advanced Nursing, 66(7), 1543–55