How to Tell a Parent Their Child is Dead or Dying
And Recover Your Own Emotional Equilibrium in a Healthy Way
What is the problem (C2)?
The CDC reports neonatal death in 2011 as ~4% per 1,000 and post-neonatal at ~2% per 1,000. In 2012, 2,274 children (age 0-17) were killed in motor vehicle related incidents – the leading cause of death for this age group. (Source: The National Center for the Review and Prevention of Child Deaths.) In California alone, 4,549 children died from all causes in 2010.
Physicians and other healthcare personnel are continually required to convey the difficult news to deeply concerned parents and families that their beloved child is dead or dying.
The way this communication is handled has a direct, permanent effect on how the family heals from this trauma – and the health of the care providers.
“The way bad news is discussed by physicians is extremely important to most parents. Parents want physicians to be accessible and to provide honest and complete information with a caring affect, using lay language, and at a pace in accordance with their ability to comprehend. Withholding prognostic information from parents often leads to false hopes and feelings of anger, betrayal, and distrust.” (1)
This communication is exceptionally taxing on healthcare professionals. Some doctors respond by hardening their communication style, which may be perceived by the family as a lack of compassion. This may increase the complaints (or even lawsuits) against the care provider or the facility itself.
Other doctors internalize the stress and their own human reaction to the patient’s family’s grief reaction. Either option increases physician stress; reduces job satisfaction; shortens tempers; encourages errors; and may incite negative interactions with other personnel. This portends long-term negative career, mental and physical health implications for the care providers themselves, and may increase the likelihood of emotional maladies such as PTSD or depression.
How do we know this is a problem (C2)?
http://www.nhpco.org/mar-06/stress-pediatric-palliative-and-hospice-care-causes-effects-and-coping-strategies
http://www.aaos.org/news/aaosnow/sep12/managing4.asp
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3327296/
(1) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3198033/
Why does this problem exist? (C2)
X Lack knowledge about the problem(s)
X Lack strategies to apply knowledge to practice (competence)
What do attendees need? (C2)
Attendees need education on how to communicate with families in supportive, clear and compassionate ways; and effective self-management techniques to reduce their own stress and emotional trauma resulting from these painful, difficult interactions.
Learning Objectives (C3)
At the conclusion of this activity, the learners will be able to:
• Know the precise words to use to communicate grievous news
• Provide a compassionate, dignified exchange with the bereaved parents
• (Potentially) minimize complaints or lawsuits against them or the facility
• Understand the toll this recurring interaction takes on them as professionals and humans
• Know and be able to execute the self-balancing strategy for emotional equilibrium
• Apply the new knowledge in practice as necessary
(IMQ’s CLC requirement)
Educational Delivery Method (C5):
- Lecture
- Question and answer session
- Handout for future reference
- “Cheat Sheet” – business-card sized offering exact language and precise instructions
(given to every participant)
Rationale for Delivery Method (C5):
- Knowledge conveyed in a short time
- Application of knowledge to all aspects of the physician’s practice
Professional Competencies (C6):
□ Interpersonal and Communication Skills – Provide communication that is compassionate and appropriate when informing parents that their child is dead or dying
□ Professionalism – Significant reduction in physician stress and the concomitant negative effects stress has on teamwork with other healthcare personnel; percentage of errors caused by chronic stress; greater physician health and resilience; and an increased confidence and awareness of how the proper communication at this critical time in the life of family can speed healing in those families.
“Wendy Keller will open your heart and teach you how to use it as an instrument of healing.”
“If I had taken this course before I started my career, it would have made the first ten years of my work so much more bearable, and probably even saved my first marriage.”
WENDY KELLER IS AVAILABLE FOR ONLINE ACTIVITIES
Wendy is available for web-based activities as well as in-person activities. She can also produce pre- and post-test questions if your organization requests for compliance with the AMA’s assessment requirement for online activities.
If your medical staff is responsible for conveying tragic information to parents, contact us here or call 800.278.8706 x711
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