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Breaking Bad News: A Phenomenological Exploration of Irish Nurses’ Experiences of Caring for Patients When a Cancer Diagnosis Is Given in an Acute Care Facility (Part 1)

Tobin, Gerard A. PhD, MSc, BSc, RGN, RMN, RCNT, RNT

doi: 10.1097/NCC.0b013e318241921d
Articles: Online Only

Background: The focus of this article is on the meanings attributed by nurses who worked with patients receiving a cancer diagnosis within acute care settings in Ireland.

Objective: The aim of this article was to explore the nurses’ perceptions of caring for patients who receive bad news in the form of a cancer diagnosis while in an acute care setting.

Methods: The article focuses on the perceptions of 20 nurses who formed the nurse participant group in a larger phenomenological study exploring giving and receiving a cancer diagnosis. Data were collected using unstructured in-depth interviews. Analysis was conducted using Koch’s analytical framework.

Results: The nurses’ narratives provided 2 emerging themes entitled, “connectedness: journeying as professional within the everyday world” and “connectedness: exclusion of professional within the everyday world.” This article focuses on the first emerging theme and highlights the experiences of nurses as they reflect on their interactions with their patients before, during, and after the giving of a cancer diagnosis.

Conclusions: This study highlights the importance of professional companionship. It provides insights into the nurse-patient challenges as a result of lack of information.

Implications for Practice: Lack of information and involvement affects the nurse’s ability to be authentically present for the recipient and results in a fracture to the nurse-patient relationship. Understanding the experiences of nurses from acute care settings where the cancer diagnosis is often given will inform and enable the nurse working in oncology settings to engage patients in a more meaningful and focused way.

Author Affiliation: Department of Nursing, University of New Hampshire, Durham.

This research study was funded by the Health Research Board, Ireland—Clinical Nursing Research Fellowship.

The author has no conflicts of interest to disclose.

Correspondence: Gerard A. Tobin, PhD, MSc, BSc, RGN, RMN, RCNT, RNT, Department of Nursing, University of New Hampshire, Hewitt Hall, Durham, NH 03824-3563 (;

Accepted for publication November 10, 2011.

© 2012 Lippincott Williams & Wilkins, Inc.