Dealing with sensitive issues
When you need to talk to a patient about something which touches on sensitive or painful issues, such as diagnosis or bereavement, there are all sorts of things which can help.
Really difficult questions patients may ask you
You know the sort of thing:
- Am I going to die?
- Will I get better?
- When am I going home?
- I don’t want my husband to know I’ve got cancer. Do I have to tell him?
These always seem to be asked in the middle of the night when there’s no-one to refer the patient on to. It’s no surprise when you’re ill and awake during the night, this is the quiet time when you have no distractions and can become very frightened about your future and have to face your worse fears. There’s no easy way to answer this sort of question but it’s very important that you’re there as another human being who can respond in some way. This can be as simple as holding someone’s hand or talking to them. The fact that you are there is the critical thing.
These are definitely mentalising moments! Always look at the emotion behind the question – does the person look anxious, distressed, resigned? What thoughts and feelings is this stirring in you?
It’s best to sit down – this tells them you’re not going to run away and that you want to encourage them to talk although you probably don’t have the answers. Rather than panicking about what to say, consciously stay calm and thoughtful; you want to find out what’s in their head so you can say things like “What’s made you ask that at the moment?” Often the patient will want to talk about how frightened they are and by sitting there and listening to their fears you are really helping. If they need or want information you will need to follow this up with their treating team.
Q.1 Whatphrases do you use,or might you use in future to ask about sensitive issues?
- I hope you don’t mind me asking but…
- If it doesn’t make you feel uncomfortable, please could you just tell me a bit more about….
- If this doesn’t feel too personal, please could you explain….
- Please feel free not to answer this, but I was wondering whether….
- It would help me understand better, but you might not want to tell me about….
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