Introduction The Covid 19 pandemic changed how we break bad news. Restrictions meant that families were no longer able to be taken to a quiet room and healthcare professionals could no longer use body language and non verbal cues to guide conversations. This small project sought feedback from bereaved relatives to create guidance on how to conduct important conversations via telephone.

Method Recruitment was via the hospital bereavement team conducting routine follow up calls to families of those who died in ICU from Covid 19. Relatives were asked if they would be willing to particiapte in feedback. 15 respondents were interviewed and asked the extent to which they agreed with statements regarding how bad news was broken to them. This was applied to a sliding scale, 1 being strongly disagree and 5 being strongly agree. Participants were also encouraged to give comment.

Results Almost all participants strongly agreed that bad news should be broken early in the conversation. A theme emerged that there was a strong preference for a direct approach. Largely, being asked if relatives were ready to have the conversation was not thought to be important but most did strongly agree that a warning shot was beneficial. A significant proportion of respondents agreed that time to react during the conversation was important. Interestingly, a number of relatives remarked on the impact of these conversations on medical staff. Respondents appreciated a kind and emotive response but this appeared less important than being direct.

Conclusion This study brought about lots of personal learning, changing my approach when teaching on the subject. Being direct and to the point was a key theme. Bad news should not be shied away from. There was an understanding that these conversations are difficult so perhaps breaking bad news could be thought of as a less daunting prospect.