Why you should read this article:

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To understand how the use of a structured framework can assist you when are breaking bad news

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To appreciate the importance of providing a suitable physical environment when engaging in challenging conversations

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To learn how to respond to emotional reactions by patients and family members when breaking bad news

Rationale and key points

Breaking bad news is a fundamental yet challenging aspect of the role of healthcare professionals, including nurses. This article provides a step-by-step framework that nurses can use when delivering bad news and having challenging conversations with patients and/or families.

• Preparation is important to ensure that challenging conversations are carried out in a suitable physical environment and with family members and/or friends present as appropriate.

• Using a framework can aid nurses when undertaking challenging conversations, ensuring that all necessary aspects of the process are incorporated.

• Nurses need to manage the expectations of patients and family members and respond appropriately to their emotional reactions.

Reflective activity

‘How to’ articles can help to update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of:

• How this article may help you to deliver bad news using a step-by-step framework in your practice.

• How you can use the information in this article to communicate effectively and address emotional distress when breaking bad news.