Communicating bad news in emergency and intensive care medicine: difficulties and strategies

Introduction: The communication of bad news is an essential component of clinical practice that can have a significant impact on the emotional well-being of patients and their families, and in emergency and intensive care environments, where decisions must be made quickly. Objective: Knowing nurses’ and doctors’ perceptions of the process of communicating bad news to critically ill people and their families in an emergency/intensive care setting. Methods: A descriptive, cross-sectional quantitative study was carried out with a questionnaire to doctors and nurses (n=67) working in these contexts in a Local Health Unit in the north of Portugal, using a non-probabilistic convenience sampling technique. Results: In the process of conveying bad news, dealing with the patient's emotions and being honest without depriving him from hope were highlighted as the two main difficulties faced. As for the main facilitating strategies to be adopted, the following stand out: trying to use understandable language, avoiding technical terms, so that the person understands what is being conveyed; answering/clearing up all questions/doubts, giving the patient/family time to assimilate everything that has been conveyed; trying to create a private, safe and comfortable environment when talking. Conclusion: The skills of breaking bad news are a fundamental component in the provision of care to patients in critical situations.