When Giving Bad News Is Part of the Job

An ER doctor’s musing on a particularly tricky occupational hazard.

Jeremy Samuel Faust is an ER doctor at Boston’s Brigham and Women’s Hospital. Part of his job is checking in with patients in the ER to see if they’re “fully oriented.”

An Emergency Doctor’s Experience Informing People Trump Is President

Just like in the movies or on Grey’s Anatomy, he asks them four questions whose answers provide a clear-enough snapshot of the patient’s awareness.

What is your name? Where are we? What is the date? Who is the president of the United States? If the person knows all four answers, they are said to be “alert and oriented to person, place, time, and POTUS.” When they get one of the answers wrong, it is good practice to reorient them.

All the questions are fine questions. What’s happening for Faust is that one of the more routine aspects of his job has taken on a slightly more sinister bent. If the person he’s speaking to doesn’t know the answer to the fourth question, he has to tell them that it’s Donald Trump.

One elderly woman let out a startling moan, the kind of sound I would have expected if someone had told her that her cat had died. Another blinked twice when I told him. “Really?” he said, in disbelief. “Come on, doc, you’re shaking my leg.” One patient accused me of playing a trick, although I have not yet been accused of bringing fake news.

Regardless of who his patients voted for, they’re often surprised to hear the news. Rather than digging deep into What This Means about the Trump administration, the American people and our hopes, fears and disappointments about our future, I’d like to instead direct our attention towards the thought of beaing the bearer of bad news. What happens when you have to give bad news at work?

There’s an art to it, I’m sure. Maybe its easier to just say it outright, without sneaking around the edge, avoiding the subject. Is there a way to do it to make it seem less bad? Sometimes it’s part of your job. Maybe you have to let someone go that day — just one person, or perhaps an entire room of people, sitting around a conference table waiting for what they already know is coming. What if it’s your entire job, though? What if you’re a debt collector? What if you spend your entire working hours on the phone to surly individuals who know they owe you money but don’t want to pay it or can’t?

What are the tactics for doing this day in and day out, without any relief? How do you handle it? How do you tell someone bad news at work?

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