Set up the Interview
- Arrange for private place
- Protected, uninterrupted time
- Arrange so everyone can be seated
Determine Participants
- News giver – knows parents/information best
- News recipients – tell parents together/support person
- Include other health care professionals
Preparation
- Know parents’/child’s name and gender
- Review what you want to communicate (may rehearse first 1-2 sentences)
- Have relevant information available
Sharing the News
- Introduce yourself
- Shake hands if appropriate
- Use of warning phrase
- Get to point quickly
- Allow parents time to absorb information
- Be comfortable with silence
- Remain present
- Personalize information
- Name diagnosis/etiology if possible
- Acknowledge uncertainty
- Address prognosis
- DON’T MAKE ASSUMPTIONS
- Balance truth with hope
Anticipate Parental Reactions
- Be prepared for sadness, anger, guilt, blame
- Allow expression of emotions
- Respond to emotions when exhibited
Negotiate Plans
- Give parents choices when possible
- Treat parents as partners
- Acknowledge and address barriers
Follow up Meeting
- Allow parents time to process information
- Encourage them to write down questions
- Meet within short time period (minutes, hours, days, weeks)
Physician Self Care
- Understand own reactions, emotions
- Sadness, anger, guilt, sense of responsibility
- Seek colleagues to gain support
- Essential to avoid burnout
