When you have to break bad news, think S-P-I-K-E-S!
" S SETTING
Set the scene by ensuring the privacy of your conversation. Select a quiet and private place in which to break the bad news. Greet your patients warmly, with a smile and make eye contact. Ensure there are no physical barriers between you and your patients.
P PERCEPTION
Assess patients' perceptions of their illnesses by asking open-ended questions. Remember the vocabulary that the patient uses and repeat their choice of words when you break the news.
I INVITATION
Invitation to impart medical information should come from your patients. The vast majority of your patients will want to know the details of their illness, but to respect those who don't, be sure to ask their preference.
K KNOWLEDGE
Knowledge should be shared with your patients by replicating their vocabulary. Give your patients small chunks of information, making sure that they understand the content after each chunk.
E EMPATHY
Empathic and exploratory responses should be used when responding to your patients' emotions on hearing the bad news. Validate their feelings.
S STRATEGY AND SUMMARY
Strategizing and summarizing will give you a chance to reiterate what has just been discussed, and provides the opportunity to raise important issues that should be covered immediately. Create a strategy so the patient knows what will happen next. "
I love clever acronyms - they help mentally overloaded physicians to remember key information better !
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