13) Breaking Bad News Flashcards
What are the 3 patterns of dying?
Gradual death
Catastrophic death
Premature death
What are some initial reactions to bad news?
Shock, numbness, disbelief, confusion
What are the 5 stages of the grief model?
Denial Anger Bargaining Depression Acceptance
What is denial?
Refusal to discuss illness/future
What are the positives of denial?
Coping mechanism
What are the negatives of denial?
Barrier for good care
Check and review over time
What is bad news?
Any information that dramatically alters a patient’s view of the future for the worse
What are the good things about telling someone big news?
May be a relief
Able to treat
Burden lifted from carer
List SPIKES:
Setting Patient's perception Invitation Knowledge Empathy Strategy/summary
Describe the setting for breaking bad news:
Face to face
Ensure privacy
Find out who patient wants present
Introduce yourself and not too many people in the room
Describe the patient’s perception stage of breaking bad news:
What does patient know already?
‘What have you been told so far?’
Describe the invitation stage for breaking bad news:
Invitation from patient to give information
May not want to know everything so respect this
Describe the way in which knowledge should be given when breaking bad news:
Give information in small chunks
Allow time for questions
Check understanding
Avoid jargon
Describe the empathetic response when breaking bad news:
Acknowledge connection between news and emotion
Listen to concerns
Validate that feeling sad/angry is normal
Describe the strategy and summary step of breaking bad news:
Summarise main topics and check understanding
Discuss next step
Opportunity to ask questions, offer further availability
Leave with other member of staff
