"I feel this is an area that I've really grown in throughout my nursing career because I was honestly very uncomfortable with these conversations as a recent graduate. Thankfully I had some great mentoring nurses in my first few years in the field. Now, when I know I need to let a patient know of a difficult diagnosis or talk to a family about a bad outcome with a patient, I start by collecting my thoughts and emotions and plan out my conversation. The next step is to find the right setting to have the conversation and I base this on who I will be talking with. If it's a conversation with family members, I look to use a family waiting room area where we can be alone and not have outside distractions. In talking to my audience, I'm very forthright with the information, discuss what the next steps are, and leave the door wide open for questions to come my way. This approach has really helped recently when a complicated surgery on a patient caused excessive bleeding and we had to keep the patient in the ICU for a few days following surgery. The patient's children were very emotional and the oldest son was very scared and fearful. My reassurance of the care they would receive in the coming days helped them understand and appreciate everything we were doing."