DOI: 10.25259/ijpc_128_2023 ISSN:

A Literature Review of Nurses Challenges and Barriers in Assisting Patients and Families Facing Breaking Bad News

Surya Wahyuni, Made Satya Nugraha Gautama, Tiur Yulianta Simamora
  • Public Health, Environmental and Occupational Health
  • Health Policy


Breaking bad news (BBN) is a challenging task for healthcare professionals, including nurses. The manner in which bad news is delivered can have a significant impact on patients and their families, either positive or negative. Understanding the roles, methods, obstacles, and challenges that nurses face in the process of delivering bad news is crucial for improving the quality of the delivery process.

Material and Methods:

This narrative review synthesises related studies. The search was conducted through PubMed, Scopus, ScienceDirect and Sage, with no restriction on publication year. The main keywords were ‘nurse’s challenge’, ‘nurse’s barrier’, ‘bad news’, ‘breaking bad news’, and ‘communicating bad news.’ A total of 12 articles were selected from 1075 articles.


Nurses play a key role in BBN before, during and after the process. Their activities include preparing patients to receive bad news, supporting patients and families when doctors deliver bad news and clarifying information obtained by patients and families regarding the prognosis of their illness. Nurses should possess skills such as building interpersonal relationships, therapeutic communication and providing emotional care for patients and their families. The main challenges and barriers for nurses in implementing BBN are due to a lack of skills and unpreparedness for patient and family reactions. After BBN, the most reported roles of nurses were supporting patients and families and helping them understand the information received from doctors. It is essential for nurses to have the necessary skills and preparedness to effectively deliver bad news to patients and their families.


Nurses play a crucial role in delivering bad news to patients and their families. They should be equipped with the necessary skills to effectively communicate with patients and their families during this difficult time. Further training for nurses in therapeutic communication, emotional care for patients and their families, and building interpersonal relationships could help to improve the quality of the delivery process.

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