Delivering bad news

This week's Independent News & Media Irish regional newspapers' column.

Michael Commane

I have been working 14 months as a hospital chaplain. It's been a life-changing experience. In the midst of pain and suffering I have had the great good fortune to see and experience first-hand extraordinary acts of kindness and goodness. All done under the radar, no fanfares, people doing amazing things.

I have had the privilege to see kindness, generosity and love being lived out with no strings attached.

Any time we are dealing with people, our behaviour and attitude are extremely important. But when it comes to engaging with people in hospital, the sick, their families and friends, it is extremely important that we are sensitive to their situation.

My mother died in 1988 and I can still remember the hospital chaplain as I stood at the bedside of my dead mother. He did not impress me. It has been a lesson to me in how not to behave.

Has it ever dawned on you what we remember from significant events in our lives, the words and actions that stay with us?

The National Cancer Control Programme (NCCP) is currently rolling out a four-hour workshop, titled ‘Delivering Bad News’, to help staff develop their communication skills. Its purpose is to give confidence and competence to staff when they are dealing with patients and families at times of bad news.

While the emphasis is on delivering bad news, the workshop gives excellent guidelines and tips to anyone who has anything to do with communications. And that surely means all of us.

The NCCP asked The Irish Hospice Foundation to design the programme, which is now being made available to all HSE staff.

I had the good fortune to attend one of the workshops.

We were a small group of six from various disciplines guided by our tutor. That it was a small group made for an ideal condition of learning, asking questions and carrying out role-play.

The workshop places great emphasis on how staff communicate with patients and families. Our tutor, who did an excellent job on the day, highlighted that at times of bad news, patients are simply incapable of taking in too much information. Naturally all clichés and jargon are out of the question. 

Kindness, gentleness and honesty reign supreme.

When someone is conveying bad news to a patient and to relatives and friends it is scientifically established that non-verbal communication has the most penetrating impact. Words account for seven per cent of what we communicate, tone of voice 38 per cent and our physical demeanour is 55 per cent.

Our behaviour, our physical deportment and our tone of voice play a far more significant role than the words we use when communicating bad news.

It makes perfect sense. Being sympathetic and empathetic, showing genuine concern and kindness is so important.

When people are hit with bad news, the words they hear are just a blur as their minds race backwards and forwards in their state of panic and fear.

When people are frightened and scared, words are usually the last thing they notice.

A day seldom passes without our health services being criticised for something or other. But guess what, there are many things they get right and very often we hear nothing about what they do well.

This workshop was excellent in every respect and I learned so much from it. Full marks to all involved.

CP Scott who became editor of the 'Manchester Guardian' when he was 25 in 1872 and spent 57 years editing the newspaper, once famously said: 'Comment is free but facts are sacred'. Wise words in the era of social media.