Communication and management of bad news to cancer patients and relatives as nursing intervention

Abstract

Introduction: The process of communicating and managing bad news in oncology is complex and susceptible of being source of discomfort for all participants. Because of their proximity to the cancer patient and family when providing care, nurses are a key element in this process, being essential to develop competencies in this area.

Objectives: Develop skills in breaking and managing bad news to the cancer patient and family, as well as to promote the improvement of nursing care.

Methods: This work was based on a project methodology. Initially the process of breaking and managing bad news was identified as a training need on a personal level by myself and by the remaining nurses of the Internal Medicine Ward, where I was working at the time. Then was performed an internship in places considered having good practices in this subject. Throughout the journey were
applied questionnaires, elaborated a Scoping Review with the Joanna Briggs Institute’s methodology, constructed documents to support the practice, made reflection on action, observed the practice of care, provided health care to cancer patient/family and performed training sessions to nurses.

Results: Skills were acquired in the use of communication techniques, in the development of the relationship with cancer patient/family and in emotional management, allowing an advanced nursing practice. The nurses who received training considered the contributions positive to their practice, enhancing the importance of knowing about guidelines for breaking and managing bad news, the discussion of case studies and the reflection about the practice.

Conclusions: It is possible to develop skills in this area based on professional experience and using this methodology, as long as nurses are aware of their training needs and are available to improve their practice. It is vital a greater investment in theoretical and practical training for the development of skills in communicating and managing bad news. The need for more scientific research in nursing dedicated to this subject is also underlined.