Communicating Distressing News

Question 1

SPIKES protocol

Answer 1

6 steps

• advance planning
• what does the patient know
• how much do they want to know
• sharing of information
• respond to emotions
• establish a plan
• common practice to use when giving distressing news*

Question 2

NURS method

Answer 2

Name
Understand
Respect
Support

Question 3

Step 1) advanced planning

Answer 3

Prepare yourself and rehearse to yourself

Have Kleenex and no cell phones

Question 4

Step 2) what do they know

Answer 4

Ask what they known already

Question 5

Step 3) what do they want to know

Answer 5

Ask what they want to know some people dont want to know

“If this turns out to be serious, do you want to know at all, if not whom should we tell”

Question 6

Step 4) sharing info

Answer 6

Avoid jargon/lingo/euphemisms

If bad give them a warning

Be direct but not brutal or insensitive

Question 7

Steps 5 respond

Answer 7

Don’t take it personally during their response.

Just be there to comfort if needed

“Hey I’m just the messenger”

NURS

Question 8

Step 6) establishing a plan

Answer 8

Make concrete plans and commit to the plans

Make sure to understand your own emotions and barriers