Breaking Bad News Flashcards
1
Q
What approach should be used to deliver bad news?
A
S.P.I.K.E.S
2
Q
What does SPIKES stand for?
A
S: Set up
- Prepare environment (privacy, noise, no interruptions)
- Ensure up to date knowledge of condition, results, prognosis, next steps.
P: Perception
- Establish what patient already knows
- Identify recent developments
I: Invitation
- Give patient ‘warning shot’
- Ask permission to deliver results/prognosis
K: Knowledge
- Clear and simple explanation
- Deliver positive news first
- Check understanding
- Repeat important points
- Use silence appropriately
E: Emotions
- Observe for and identify emotion, observe for ‘shut down’
- Give pt time
- Acknowledge emotion
- Encourage expression of feelings
S: Strategy
- Make plan together
- Summarise
- Repeat important points
- Check understanding
- Invite questions
- Offer ongoing assistance in case of further questions
3
Q
What should be done after a consultation where bad news has been delivered?
A
- Inform other relevant healthcare professionals
- Letters should explain what the patient has been told
4
Q
What should be considered in follow up for a patient who has received bad news?
A
- Early follow up
- Offer to tell patient’s relatives/do it together
- Identify support systems
5
Q
How should confidentiality be ensured when breaking bad news?
A
- Avoid informing relatives first
- Always get permission before informing relatives
- Do not assume patients want relatives present
