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I talk about disclosing diagnosis or sharing unexpected news in a lot my book. I've given talks about best practice about this over the years.
I draw upon my stories of learning that my son had Down syndrome and then finding out that I had cancer 13 years later. /1
I draw upon my stories of learning that my son had Down syndrome and then finding out that I had cancer 13 years later. /1
It is hard for both the sharer of the news (usually a physician) + the receiver of the news (a patient +/or family).
Typically, I'd say it is best to share news in person. But these are not typical times. /2
Typically, I'd say it is best to share news in person. But these are not typical times. /2
I think sensitive + respectful conversations can still happen over the phone, even with people you don't know. The same best practices can apply.
My own cancer diagnosis was given over the phone by my family doc and it was done very well, with respect + compassion. /3
My own cancer diagnosis was given over the phone by my family doc and it was done very well, with respect + compassion. /3
Here's what worked well. If possible:
Schedule a specific time instead of calling out of the blue.
Suggest the person has a support person with them or someone lined up they can follow up with.
Give the most important information first.
Allow for silence to digest the news. /4
Schedule a specific time instead of calling out of the blue.
Suggest the person has a support person with them or someone lined up they can follow up with.
Give the most important information first.
Allow for silence to digest the news. /4
Instead asking:
Do you have any questions?
Consider saying:
What questions do you have + then waiting for three full seconds for an answer. /5
Do you have any questions?
Consider saying:
What questions do you have + then waiting for three full seconds for an answer. /5
At stressful times, I've totally forgotten what was actually said because I was having a traumatic response, like feeling as if I was floating over my body.
Offer ways to follow-up + send written information. A follow-up phone call a day later is so greatly appreciated.
/6
Offer ways to follow-up + send written information. A follow-up phone call a day later is so greatly appreciated.
/6
Do not be afraid of tears - from you or the pt/family.
When my doctor told me I had breast cancer, she started to cry. This gave me permission to cry too. It was a relief to cry together.
She showed me she was human + that she cared about me too. This was a gift to me. /7
When my doctor told me I had breast cancer, she started to cry. This gave me permission to cry too. It was a relief to cry together.
She showed me she was human + that she cared about me too. This was a gift to me. /7
If you have these difficult conversations, please take care of yourself.
Prepare and take a deep breath before you pick up the phone. Honour the gravity of what you are about to do. Lean on team members to provide support to you.
This is hard but important work. /8
Prepare and take a deep breath before you pick up the phone. Honour the gravity of what you are about to do. Lean on team members to provide support to you.
This is hard but important work. /8
Finally, I'd recommend this beautiful sad essay from 2016 from Dr. Naomi Rosenberg. It makes me weep every time I read it, because of the humanity expressed by the physician. /fin https://www.nytimes.com/2016/09/04/opinion/sunday/how-to-tell-a-mother-her-child-is-dead.html
