Breaking Bad News Flashcards
Explain the implications for patients if bad news is not delivered well
Impact on: Doctor/patient relationship Emotional well-being Adjustment to/ability to cope with illness Threat to mental/physical well-being
Explain why it is important to tell patients when there is bad news
Maintain trust
Reduce uncertainty
Prevent unrealistic expectations
Allow appropriate adjustment
Promote open communication
Most patients with to know their diagnosis and be informed about the progress of treatment/disease
Lack of information can lead to uncertainty, anxiety, distress
Describe ‘blocking behaviours’ in breaking bad news
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Explain why it is difficult to break bad news
Unleashing powerful emotions Desire to 'protect' patient Fear of patient's reaction (blame) Sense of failure as a doctor Feeling embarrassed about how to offer comfort
Describe each step in the ‘SPIKES’ model of breaking bad news, with examples of good practise for each step
Setting - face to face, privacy and no interruptions, introductions, few staff, tissues available
Patient’s perception - find out what patient already knows
Invitation to give information - ask how much they would like to know, allow for denial and offer opportunity for further discussion
Knowledge - warning shot, information slowly and in small chunks, avoid jargon
Empathy
Summary - summarise, ask if there are questions, inform availability to ask questions/find out more
