40. bad news

Question 1

when giving bad news ensure (2)

Answer 1

1) setting is appropriate

2) pt’s confidentiality

Question 2

before envolving the family you need

Answer 2

pt consent

Question 3

how to give bad news (3) social techniques

Answer 3

1) in an empathic, compassionate manner

2) allowing enough time

3) providing translation, as necessary

Question 4

After giving bad news arrange for

Answer 4

follow up / R/A

• impact
• understanding

Question 5

Approach to breaking bad news (SPIKES)

Answer 5

S : Setting
- gather all the info, arrange privacy etc

P: Perception
- what have you been told so far
- what is your understanding

I : invitation
- how would you like me to give the information
- how much detail
- focus on tx plan?

K : KNOWLEDGE
- warning shot
- small chunks
- dx, tx, prognosis, support

E: EMOTIONS
allow time
identify emotions

S: strategy and summary
- questions
- support

Question 6

how to to give a warning shot

Answer 6

I’m afraid I have some bad news

I wish things were different, I wish I could say that

I’m sorry to tell you that…