The perils of overpromising

In any professional setting, communication is key. This is especially true in healthcare, where clear, accurate, and compassionate communication can significantly impact patient experience. Last week, while leading an advanced communication skills course with a group of oncology nurses, an important issue came to light that underscores the risks of overpromising.  This is particularly important in high-stakes environments like healthcare.

One of the nurses shared a communication challenge that involved a common, yet critical, issue: when a consultant overpromises something to a patient that isn’t realistic. This could range from suggesting that treatment will begin within the next few days or that a patient can go home with their prescribed medication today.  Often, despite the need to follow certain procedures or policies.  As a result, the nurse and/or pharmacist faces the difficult task of managing the patient’s expectations. Subsequently, leaving them handling the fallout of disappointment, frustration, or even anger.

The nurse or pharmacist must navigate the disappointment created. The nurse is often on the front line of this difficult conversation.

Why Overpromising is Problematic

  1. Creates False Expectations When someone is told that a particular outcome is possible, they build expectations around it. In healthcare, where patients are often dealing with high levels of anxiety or vulnerability, these expectations can mean everything. If the reality doesn’t match the promise, the emotional fallout can be significant—anger, fear, or disappointment.
  2. Erodes Trust When we break a promise, it becomes harder to regain trust. Patients may start to distrust not only the individual consultant but the entire healthcare team, including nurses, pharmacists, and other professionals. Trust is the foundation of effective communication and care, and losing it can damage patient relationships and outcomes.
  3. Puts Colleagues in Difficult Situations As seen in the example with the oncology nurse, overpromising can cause downstream challenges for the entire team. Nurses, pharmacists, and support staff often manage unrealistic patient expectations, which creates tension, conflict, and stress within the team. Overpromising makes life complicated for everyone involved.

So how do we avoid this pitfall? What alternatives do we have to overpromising, especially when we feel the urge to give patients or clients hope and make a difficult situation more bearable?

What Can Be Done Instead?

  1. Set Realistic Expectations Early One of the most effective ways to avoid overpromising is to set realistic expectations from the outset. For example, rather than saying, “You’ll be able to start treatment in a few days,” a more accurate statement might be, “The nursing team or pharmacist will discuss the next steps with you soon, and they will provide you with a clearer timeline.” This way, the patient knows that while the goal is to start treatment soon, there are steps that must be completed first, and other team members will be involved in communicating the details.
  2. Focus on What You Know For Sure If you’re uncertain about timelines or outcomes, focus on what is definite. For example: “We’re working on getting you started with treatment as quickly as possible. I don’t have an exact timeline at the moment, but the team is doing everything they can to expedite the process.” This acknowledges the patient’s desire for swift action without committing to a timeframe you can’t guarantee.
  3. Use Supportive Language to Acknowledge Emotion Patients often want reassurance that something is being done. However, instead of overpromising, use supportive language to manage their emotions. For example: “Waiting can be frustrating, but I want to assure you that the team is prioritising your care, and we’ll update you as soon as we have more information.” This not only offers reassurance but also shows empathy for the patient’s situation.
  4. Delegate the Promise to the Right Person Instead of making a promise about something that may not be in your control, direct the patient to the appropriate person who can give them accurate information. For instance, saying, “The pharmacy team will confirm when the medication is ready, and they will let you know if there are any delays,” ensures that the patient gets the right information from the right source. Therefore, helping to avoid potential miscommunication or disappointment.
  5. Be Transparent About Uncertainties Patients often appreciate honesty. If there are factors that could delay treatment or medication, explain these uncertainties up front. For example: “We’re hoping that the treatment will begin soon, but there are a few processes and checks that need to happen first. I’ll keep you informed at every stage so you know exactly what to expect.”

Conclusion: Building Trust Through Communication

In any professional environment, especially healthcare, overpromising can create a host of issues—broken trust, disappointed patients, and strained team dynamics. While the intention behind overpromising may be well-meaning, the consequences often lead to more harm than good.

The key is to manage expectations realistically while still offering hope and reassurance. Involving the appropriate team members, using clear and compassionate language, and being transparent about uncertainties can build trust and help avoid the fallout from overpromising. In the end, it’s about delivering a message that’s honest and helpful without overstating what’s possible.

By focusing on what’s realistic and being clear in our communication, we can ensure that patients feel supported.  We can also ensure we don’t leave our colleagues to clean up the mess when promises fall through.

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