In 2000, Jurkovich published in the Journal of Trauma a study evaluating family perspectives on communication of bad news by health care providers. The bad news being communicated in this study was that of death that occurred after arrival at the hospital, either in the ICU setting or in the emergency department: 69% of patients died within 2 days, and 83% died within 1 week. Surviving family members were given a survey tool to evaluate the importance of certain aspects of the communication of such news.

In order of importance, the families were found to value the attitude of the news-giver; clarity of the message; privacy of communication; the news-giver’s knowledge and ability to answer questions.

How do we translate those results into practice?

First, we should prepare ourselves mentally for the discussion. Briefly rehearse what will be said and review any pertinent clinical information in case the family has questions. Have the discussion in a quiet setting that will provide privacy and minimize interruptions. The importance of speaking in understandable, non-medical words cannot be overstated. Fewer things will place a greater distance between the provider and the recipients of the information.

Empathetic statements such as “I am very sorry” are simple but are important for family members to hear.

These discussions will continue to be difficult to have. There is no Survey Monkey feedback. No family reaction will let you know that you did a great job. There is really no such thing as a great job. In a sense, it will always feel like a “did the best I could” scenario. It is just the nature of the discussion.

Asking a colleague to join you in talking with the family may provide some objective feedback on how to improve. But ultimately each family and clinical situation will be different. We can only be mindful of some simple things and do the best we can.

Dr. Kazzi is an emergency medicine resident at SUNY Downstate Medical Center in Brooklyn, N.Y.