VMDiva

I was recently unpleasantly surprised with the diagnosis of a bone tumor in a young golden retriever I was convinced had a cruciate ligament tear. The ensuing conversation blindsided the pet owners and I was reminded of the importance of delivering bad news properly. I’m not the most articulate person but as I travel along in my veterinary career I have learned invaluable lessons in the delicate art of breaking bad news. Below is a short list of insights that may help an unsuspecting new veterinarian.

Be honest and forthright.

I am not a fan of the question “What would you do if he was your pet?” While I offer my opinion when solicited, I always note that I have a bias. That bias is what makes me a veterinarian. My job is to cure and treat disease, alleviate pain, and want to find the diagnosis. If you think an animal is suffering, kindly say so. Veterinarians sometimes better recognize the signs of pain, discomfort, and failing quality of life.

Get to the point. Repeat.

When delivering bad news to an owner, like the diagnosis of a tumor, it is tempting to talk about normal results and how the animal arrived at this point before giving the diagnosis. It just doesn’t work. Most people are perceptive enough to sense something is dramatically wrong and their minds begin racing as soon as you don’t say everything is okay. I find the most effective way to deliver the blow is with a soft voice, caring personal tone, and preface the entire conversation with “I’m afraid I have some very bad news for you, it appears as though Fluffy has a tumor in his abdomen that looks as though it has spread to his chest. I know this is a lot to handle but I’d like to discuss it with you.”

Further discussion at that time is completely dependent on the owner. Some owners want to discuss all options then and there. Others need time to digest the information and will need to call or visit later. Determining what the owner needs is a skill a vet develops over time. Too many times I have tried to plow through a discussion of what we do next only to realize the owner hasn’t moved beyond the word “cancer”. Once you deliver the news, summarize the findings again. In a state of shock, owners may remember only a fraction of what you tell them.

Don’t Use Euphemisms

It may be tempting to sugar coat findings to try to spare emotions but you will do a disservice to your patient if you fail to adequately explain the dire situation to its owner. A gentle apologetic tone prevents you from sounding too calloused. For suddenly deceased pets, using terms like “moved on”, “passed on”, and “no longer with us” are not definitive for a reeling mind. Use the terms “death” and “died” at least once in conversation and supplement the conversation with the other terms.  For the terminal diagnosis, terms like “life-ending”, “end-stage”, and “not recoverable” are warranted. In addition, “uncomfortable” does not mean the same thing as “suffering” to most owners so choose your descriptors wisely.

Offer Follow-Up

Once you’ve delivered the news, acknowledge there will be more questions. Suggest owners write them down, sleep on it, and call you the next day with questions. Make yourself available for a consulation appointment as some owners prefer speaking in person.

Be Compassionate

You’ve just rocked someone’s world. Remember what it is like to be confused and stunned. Don’t be afraid to reach out and hug a client in need.