As optometrists, we all know that communication is key. It’s one of the core competencies of the General Optical Council, and it’s something we use every day when interacting with patients, colleagues, and the general public.
But let’s face it, not all news is good news. Sometimes, through the course of an appointment we find abnormal findings and be in a situation where we have to deliver bad news to our patients. It’s never easy but there are ways to make the process a little smoother for everyone involved.
Compassion is Key
First and foremost, remember that there’s a human being on the receiving end of your words. They might be scared, anxious, or worried about what’s happening, especially if they have presented to you with problems.
It’s crucial to approach these empathy and compassion. When someone reaches out for help or guidance, acknowledging their emotions and providing a sense of solidarity can make a world of difference. By affirming their emotions and expressing genuine concern, you create a supportive environment that fosters trust and comfort. This human connection can provide a huge reassurance, even in the face of difficult news or challenges. Remember, a kind and caring approach can have a tremendous impact on someone’s well-being, making them feel understood and valued during challenging times.
Let them know that you care and that their welfare is your priority. While this won’t make the news any less difficult to hear, it will reassure them that they’re not alone.
Deliver with Confidence
It can often be that the discovery of an abnormal finding triggers different emotions within. It could be in the form of excitement as it is the first time you have picked up a retinal tear or viewed papilloedema, but it could also spark fear or worry for your patient.
Personally, I find panic tries to find its way into me as I worry about the well-being of my patient as well as making sure I do the best I can for them, whilst doing so in a busy clinic. Through the years I have managed to control these feelings. I have found that doing the following helps.
When delivering bad news, it’s crucial to remain calm, composed and collected . Begin by taking a deep breath to center yourself, allowing you to explain your findings in a clear, steady voice. It’s important to anticipate potential questions and have a well-thought-out plan of action prepared. By doing so, you will be able to convey professionalism and confidence, ultimately making the news more manageable and well-received.
Honesty is the Best Policy
While it might be tempting to avoid the truth or soften it, honesty remains paramount. Imagine a patient, teary-eyed in your chair, just diagnosed with a severe sight-threatening condition, asking through their sobs, “Am I going blind?” Our instinctive human response might be to reassure them by saying “No, you aren’t going blind”, even when their prognosis is indeed grim. Despite the difficulty, it’s crucial to share the facts with the patient, inform them about the steps you’re going to take for them, and emphasise any critical information that could help them, such as an emergency referral or resources for low vision or charities.
We have a duty of candor, so if something isn’t right, tell the patient. Withholding information can lead to misdiagnosis, lack of action by the patient, and even harm. Furthermore, should you not inform the patient that there is indeed bad news and that you have withheld it from them, then there is a high chance of recourse through complaints, loss of trust and even litigation.
Document Everything
The importance of maintaining detailed and exhaustive records of all appointment events cannot be stressed enough. By recording your observations, the specifics of your patient interaction, and your planned course of action, you can effectively revisit and convey the appointment details to the patient, their family members or representatives (if needed) later on.
Moreover, this thorough documentation acts as a safety net, for you as an optometrist, should legal disputes arise. The records will provide a concrete record of the actions undertaken and decisions made, providing evidence of how you have acted in the best interest of the patient.
Offer Solutions
When faced with bad news, most people want to know what can be done to fix the situation. Some solutions are easier than others, but there’s always something that can be done to help. Be aware of local support groups, low vision pathways, and the latest low vision aids. You might not be able to improve their eyesight, but you can help them maximise the support they receive.
Keep in mind that an eye examination should consider the patient holistically. For instance, you might have had to inform a patient that they no longer meet the visual standards for driving. However, they initially came to you struggling to watch their TV, and the refraction you achieved provided them with three additional lines of vision compared to their current glasses. If you detect signs of a cataract – which may upset the patient – inform them about the treatment options, interim measures you can take, and reassure them if their worries significantly exceed your findings.
There is always something you can do for the patient, even if it isn’t directly related to the concerns at hand. Offering this help will further increase their trust in you and reassure them that you are a healthcare professional that cares.
Take Care of Yourself
Breaking bad news is always a challenging task, and it can significantly impact your own mental well-being. It’s essential to prioritise self-care in these situations. Discover a coping mechanism that resonates with you and fits within your working pattern. It could be allowing yourself a moment of vulnerability with a good cry, channeling your emotions into a vigorous workout at the gym, or seeking solace in a conversation with a friend (but be mindful of patient confidentiality). These strategies can help you process your feelings and maintain your mental health.
Always remember, you’re doing the best you can under the circumstances. Even though the news might be hard for the patient to hear, in the long run, they will benefit from knowing the truth and being able to make informed decisions about their health.
Delivering bad news is never a straightforward task, but approaching it with compassion, confidence, and honesty can make the process more manageable for everyone involved. Adding a touch of self-care to this mix not only helps you maintain your emotional balance but also equips you to handle such situations more effectively. Remember, your well-being is just as important in ensuring the patient receives the care they need.
Summary
Overall, whilst delivering bad news is not an easy task, it is one task that you will have to perform regularly in your role as an optometrist. That said, there are ways that you can prepare yourself to deliver the news confidently and empathetically that will both inform and reassure the patient whilst maintaining your mental well-being.
I hope this article has been beneficial to you and your development as an optometrist. Have you had to break bad news since qualifying? Do you have any tips on how you have managed to successfully deliver it? Have you ever had to deliver bad news and the patient take it in an unexpected way? The Eye Care Advocate would love to hear your comments below!
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