How to break bad news
Intended for healthcare professionals
Evidence and practice    

How to break bad news

Aby Mitchell Senior lecturer in nursing education, Adult Nursing, Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King’s College London, London, England

Why you should read this article:
  • To understand how the use of a structured framework can assist you when are breaking bad news

  • To appreciate the importance of providing a suitable physical environment when engaging in challenging conversations

  • To learn how to respond to emotional reactions by patients and family members when breaking bad news

Rationale and key points

Breaking bad news is a fundamental yet challenging aspect of the role of healthcare professionals, including nurses. This article provides a step-by-step framework that nurses can use when delivering bad news and having challenging conversations with patients and/or families.

• Preparation is important to ensure that challenging conversations are carried out in a suitable physical environment and with family members and/or friends present as appropriate.

• Using a framework can aid nurses when undertaking challenging conversations, ensuring that all necessary aspects of the process are incorporated.

• Nurses need to manage the expectations of patients and family members and respond appropriately to their emotional reactions.

Reflective activity

‘How to’ articles can help to update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of:

• How this article may help you to deliver bad news using a step-by-step framework in your practice.

• How you can use the information in this article to communicate effectively and address emotional distress when breaking bad news.

Emergency Nurse. doi: 10.7748/en.2023.e2174

Peer review

This article has been subject to external double-blind peer review and checked for plagiarism using automated software



Conflict of interest

None declared

Mitchell A (2023) How to break bad news. Emergency Nurse. doi: 10.7748/en.2023.e2174


Please note that information provided by Emergency Nurse is not sufficient to make the reader competent to perform the task. All clinical skills should be formally assessed according to policy and procedures. It is the nurse’s responsibility to ensure their practice remains up to date and reflects the latest evidence

Published online: 20 June 2023

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