How to break 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.