Ask an NP – My Most Difficult Conversation

00:01 The most difficult conversations to have with patients, for me so far have been when the news is not good.

00:06 And you're the one who's going to be relaying it to them.

00:09 And there's no great way to have that, right? Because even if you say, "Hey, you know, do you want to have someone else here with you?" It immediately clues them in this isn't good.

00:19 The best way, you know, that I've found is to be honest, because that's what I would want with someone, if they were talking to me about it would be to be honest.

00:26 And so saying, hey, and coming straight out and saying, I don't have the best news.

00:30 That automatically lets them know that this and the next follow up question is, do you want to talk about this now? Do you want to go get someone? Do you want to come into the office? If this is over the phone. I want to explain it to you.

00:42 And then when you deliver bad news, going over, usually having the report of whatever it is in front of you.

00:48 So you can highlight one line and show them and don't go much deeper than that.

00:53 And understanding that people really, they're not there to hear your whole explanation of a treatment plan.

00:58 I let them know what it said.

00:59 And then we usually give them one following step.

01:02 "Hey, this is what we're going to do.

01:04 You know, I am going to contact these people, you will be getting a phone call from this office." And that's our one step.

01:10 When you have the brain space, write all your questions down and then you can bring them to me and we'll go over them.

01:15 But you don't answer a lot of questions that day.

01:17 And there's not even honestly a lot you can say usually to comfort people other than I pull up a chair, if they're fine with me sitting there and like putting my hand or like my arm around them, asking them, "Can I touch you? can I hold your hand?" Can I whatever just being physically they're for them.

01:32 And that's really all you can do in those instances.

01:34 I found not overdoing it is helpful though because at first I tried to explain treatment options and you want to give them comfort but I found that's not how people receive comfort in those situations.