Advanced Practice

Collaborative Practice Model: Improving the Delivery of Bad News

Pamela N. Bowman

Kim Slusser

Deborah "Hutch" Allen
bad news, communication, palliative care, end of life, cancer
CJON 2018, 22(1), 23-27. DOI: 10.1188/18.CJON.23-27

Ideal bad news delivery requires skilled communication and team support. The literature has primarily focused on patient preferences, impact on care decisions, healthcare roles, and communication styles, without addressing systematic implementation. This article describes how an interdisciplinary team, led by advanced practice nurses, developed and implemented a collaborative practice model to deliver bad news on a unit that had struggled with inconsistencies. Using evidence-based practices, the authors explored current processes, role perceptions and expectations, and perceived barriers to developing the model, which is now the standard of care and an example of interprofessional team collaboration across the healthcare system. This model for delivering bad news can be easily adapted to meet the needs of other clinical units.


  • The optimal delivery of bad news is an interprofessional and collaborative event.
  • Delivery of bad news can be distressing to patients, families, and staff when not performed effectively.
  • Advanced practice nurses have an opportunity to model positive behaviors that support the effective delivery of bad news.
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