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Block 4 > Breaking Bad News > Flashcards

Flashcards in Breaking Bad News Deck (5)
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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