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Breaking the worst possible news in the best possible manner

Hearing that a loved one has died after trauma could be the most emotionally devastating news one might ever hear. How this news is delivered has an immense impact on how people will later reflect on those initial moments of loss.

"You have to know that you're creating a lifelong memory -- people will likely remember every detail of the conversation. Even if they don't remember the words, they will remember the feelings," says Becky Pierce, nurse manager of the Trauma Intensive Care Unit (TICU) at Harborview Medical Center in Seattle, who has spoken on the topic nationwide.

At Harborview, a study began in 1996 on how to best break bad news to people close to trauma victims. Interviews were conducted with 50 family members about six months following the death of a loved one who was treated in the Emergency Room or the TICU. The findings were presented Sept. 17 at the American Association of the Surgery for Trauma in Boston by Dr. Gregory Jurkovich, chief of trauma at Harborview Medical Center and professor of surgery at the University of Washington School of Medicine.

The nurses who conducted these interviews sensed that those who felt their situations were handled well were able to move on more easily. "Although several people refused to respond initially, they later changed their minds," says Pierce. "It was found that people were hungry to talk about their experiences and that everything was crystallized in their minds. If their memories were bitter, the anger was instantly expressed."

The most important aspects of delivering bad news were attitude, clarity of information and privacy. "People didn't like being strung along, and didn't want any sugar-coating," she says. "They also didn't think that touch or hugs were important -- in fact all the men said that anything more than a handshake was inappropriate. According to social workers, unwelcome touch interrupts with the necessary flow of emotions."

Doctors are advised to feel their way
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Contact: Ellen Liang
eliang@u.washington.edu
206-731-3753
University of Washington
17-Sep-1999


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