How to Cope with Loss, Grief,
Death & Dying - Professionally & Personally
© 2002 Kirsti A. Dyer,
MD, MS All Rights Reserved. E-mail: email@example.com
The California Maritime
Academy - CSUM California State University, Maritime
SOC 210. Dying: The Final
Stage of Living February 7, 2002
Dealing with Bad News
ABCDE’s of Delivering Bad News
What the person already know/understand
Arrange for the presence of
a support person and appropriate family.
Arrange a time and place to
be undisturbed—no pagers or cell phones.
Prepare yourself emotionally.
Decide on which words and phrases
to use—write a script.
Build a therapeutic environment/relationship
Arrange a private, quiet place
Provide adequate seating for
Sit close enough to touch if
Reassure about pain, suffering,
Be direct - "I am sorry that
I have bad news for you."
Do not use euphemisms, jargon,
Use the words – "Cancer," "AIDS,"
"Death," "Died" as appropriate.
Allow for silence.
Use touch appropriately.
Deal with patient and family
Assess person’s reaction: body
responses, cognitive coping strategies, affective responses.
Listen actively, explore, have
Encourage and validate emotions,
Evaluate the News
Address further needs:
Make appropriate referrals for
Explore what the news means
to the person.
Express your own feelings.
What are the person’s immediate
and near-term plans?
Is there any indication of the
person feeling suicidal?
Choose a quiet setting.
Give the news in person, if
Assess the person’s present
physiologic and emotional state.
Prepare the person by saying
there is a difficult topic to discuss.
Use clear, simple language.
Express sorrow for the person’s
pain; be human.
Be realistic; avoid minimizing
Don’t take away all hope.
See how the person feels after
hearing the news. Know of your resources for referral e.g. grief support
Rabow MW, McPhee SJ.
Beyond breaking bad news: how to help patients who suffer. WJM 1999;171:260-263. Available as PDF file at: http://www.ewjm.com/cgi/reprint/171/4/260 http://www.ewjm.com/cgi/reprint/171/4/260 .
Miranda J. Brody RV.
Communicating bad news. WJM 1992; 156:83-85.
© 2002 Kirsti
A. Dyer, MD, MS, FAAETS. Journey of Hearts, www.journeyofhearts.org.
All rights reserved.
A single copy of this
article can be made for personal or professional use.
Contact Dr. Dyer at firstname.lastname@example.org
for permission to use materials from this presentation for other ventures.