Original Research

‘I am afraid the news is not good’ – Breaking bad news in the time of COVID: Experiences from a field hospital

Charmaine Cunningham, Pat Mayers, Janet Giddy, Magdaleen de Swardt, Peter Hodkinson
African Journal of Primary Health Care & Family Medicine | Vol 16, No 1 | a4256 | DOI: https://doi.org/10.4102/phcfm.v16i1.4256 | © 2024 Charmaine Cunningham, Pat Mayers, Janet Giddy, Magdaleen de Swardt, Peter Hodkinson | This work is licensed under CC Attribution 4.0
Submitted: 30 July 2023 | Published: 23 February 2024

About the author(s)

Charmaine Cunningham, Department of Family, Community and Emergency Care, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
Pat Mayers, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; and School of Nursing, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa
Janet Giddy, Médecins Sans Frontières, Cape Town, South Africa
Magdaleen de Swardt, Department of Family, Community and Emergency Care, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
Peter Hodkinson, Department of Family, Community and Emergency Care, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa

Abstract

Background: The COVID-19 Pandemic had profound effects on healthcare systems around the world. In South Africa, field hospitals, such as the Mitchell’s Plain Field Hospital, managed many COVID patients and deaths, largely without family presence. Communicating with families, preparing them for death and breaking bad news was a challenge for all staff.

Aim: This study explores the experiences of healthcare professionals working in a COVID-19 field hospital, specifically around having to break the news of death remotely.

Setting: A150-bed Mitchells Plain Field Hospital (MPFH) in Cape Town.

Methods: A qualitative exploratory design was utilised using a semi-structured interview guide.

Results: Four themes were identified: teamwork, breaking the news of death, communication and lessons learnt. The thread linking the themes was the importance of teamwork, the unpredictability of disease progression in breaking bad news and barriers to effective communication. Key lessons learnt included effective management and leadership. Many families had no access to digital technology and linguo-cultural barriers existed.

Conclusion: We found that in the Mitchell’s Plain Field Hospital, communication challenges were exacerbated by the unpredictability of the illness and the impact of restrictions on families visiting in preparing them for bad news. We identified a need for training using different modalities, the importance of a multidisciplinary team approach and for palliative care guidelines to inform practice.

Contribution: Breaking the news of death to the family is never easy for healthcare workers. This article unpacks some of the experiences in dealing with an extraordinary number of deaths by a newly formed team in the COVID era.


Keywords

COVID-19; palliative care; South Africa; communication; attitude to death; terminal care; qualitative research

Sustainable Development Goal

Goal 3: Good health and well-being

Metrics

Total abstract views: 703
Total article views: 670


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