Nursing Conversations 4 — Breaking Bad News AE

The language of difficult conversations — supporting patients and families through bad news with compassion, honesty, and professionalism.

Breaking bad news in nursing

Breaking bad news is one of the most challenging things a nurse does, and language is the primary tool. The SPIKES protocol — Setting, Perception, Invitation, Knowledge, Empathy, Strategy — provides a framework, but this exercise focuses on the actual language: how to be honest without being brutal, empathetic without being patronising, and clear without being clinical.

Ready to practice! Let's go!

Choose the most natural-sounding response. LEVEL: Advanced

1. Before delivering difficult news, what should you do first?
2. How should you open a conversation about bad news?
3. A patient bursts into tears when you share the news. What should you do?
4. A patient asks "Am I going to die?"
5. A patient says "I don't understand what you're telling me."
6. A family member says "Why didn't you catch this sooner?"
7. After delivering bad news, what should you always do?
8. A patient says "I don't want any treatment."
9. A patient becomes angry after hearing their diagnosis. What should you do?
10. How should you close a difficult conversation?
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