BAD NEWS IN CRITICAL CARE AND EMEREGENCY UNITS AND NURSES’PARTICIPATION IN THE PROCESS OF BREAKING BAD NEWS IN AFFILIATED HOSPITALS OF TEHRAN UNIVERSITY OF MEDICAL SCIENCES

Breaking bad news is one of the challenges in intensive care units and
emergency departments. Nurses as a person who has responsibility for continuous caring, has a
significant role in the process of breaking bad news, but little has been done to explore this issue. The
purpose of this study was to determine types of bad news common in intensive care units and
emergency departments and to investigate nurses ‘participation in the process of breaking bad news.
Materials & Methods: In this descriptive study, a sample of 182 nurses working at intensive care units
and emergency departments of the hospitals affiliated to Tehran University of Medical Sciences
selected in a quota and stratified sampling method. The data collection tool was a self-reported
questionnaire which query common bad news that nurses encounter, and the activities they involved in
breaking bad news.
Results: According to the findings, news about death was the most common news in CCU (89/5%),
ICU (77/3%), and emergency departments (81/8%). The most important activities that nurses had been
involved were emotional support of patients and relatives (2/79±0/95), explaining the physician’s
speech in a simple manner (2/68±0/96), helping patients or relatives adapt with bad news over time
(2/63±0/89), preparing the patient or his/her relative for hearing bad news (2/6±1/04). The results
showed 34.1% of nurses break bad news to a patient or his/her relative independently.
Conclusion: This study showed the scope of bad news in intensive care units and emergency
departments is broad and diverse. Also, nurses are mostly involved in activities related to breaking bad
news. Therefore, educating nurses about breaking bad news and providing regulations to support them
about this issue seems to be necessary.