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Healthcare practitioners' experiences of breaking bad news: A critical interpretative meta synthesis
Laura Francis1, Noelle Robertson1
1School of Psychology and Vision Sciences, University of Leicester, George Davies Centre, Lancaster Road, Leicester LE1 7HA, UK.
Objective:
To provide an overview of healthcare practitioners' experiences of breaking bad news.
Method:
Interpretative meta synthesis of 14 qualitative papers identified through a systematic search. Data were extracted and constructs elicited via reciprocal translational analysis.
Results:
Findings comprised four inter-connected themes: (1) Discomfort, particularly difficult emotional and physical responses to breaking bad news; (2) Relational distress, connected to attachment and identification with patients; (3) Inadequate clinician, indicating the fear and rumination about the possibility of getting it wrong and the subsequent self-blame; and (4) Only human, highlighting a culture of invulnerability where practitioner self-care is deprioritised.
Conclusions:
Breaking bad news provokes significant distress for practitioners, particularly where they experience strong attachment to or identification with a patient. Breaking bad news was understood as an isolating experience and staff's non-disclosure of difficulties appeared to sustain a culture of invulnerability in which admission of distress was not encouraged.
Practice Implications:
Given the adverse impacts and potential for practitioner burnout, organisations should acknowledge ramifications and offer time for staff to process the delivery of bad news, promote a culture of collective care and provide space for reflective practice.
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