This document discusses breaking bad news to patients. It begins by defining bad news as information that seriously affects a patient's view of their future health. Examples of bad news include cancer diagnoses or recurrence. The document explains that it is important for physicians to learn how to break bad news because patients want honesty, it is a frequent task, and it has ethical and legal implications. It then outlines the five stages of grief that patients may experience and recommends using the SPIKES protocol for breaking bad news, which involves setting up the conversation, assessing the patient's perspective, obtaining permission, sharing knowledge, addressing emotions, and summarizing. Finally, it provides references on breaking bad news and discusses using examples to illustrate the grief stages in different scenarios

1. Breaking
Bad News
Dr. Shazia Iqbal
Assistant Professor
Director of Medical Education Unit
Vision College of Medicine,
Riyadh

2. Objectives
What is a Bad News? Why is it Important to
Learn to Break Bad News?
01
5 Stages of Grief and Loss.
03
How to break Bad News.
04
Discuss examples and Patrice 5
stages in different scenarios .
05
02

3. What is a Bad
News?
Any information that adversely
and seriously affects an
individual’s view of her/his
future life.

4. Some Examples of Bad News
Disclosing:
diagnosis of cancer
cancer recurrence
Positive genetic test results
Presence of an irreversible disease
01
02
03
04

5. Why is it Important to Learn
to Break Bad News?
- patient want the truth
- a frequent but painful task
- clinical outcomes
- ethical and legal imperatives

7. Many NPs view breaking bad news as a
communication skill that is important for
clinicians working in end-of-life care,
where the news can be that treatment has
been unsuccessful leaving few options for
disease control, or that death is imminent.

8. As Physician . . .
You are Expected to Break
Bad News to the Patient or
his/her family.

9. 5 Stages of
Grief and Loss:

10. How to break Bad
News?
Six Steps of Spikes
04

11. S SETTING UP the interview
P Assessing the patient’s PERCEPTIONS
I Obtaining patient’s INVITATION
K Giving KNOWLEDGE to the patient
E Addressing patient’s EMOTIONS with empathy
S STRATEGY and SUMMARY
Six Steps of Spikes

13. Discuss examples and
Patrice 5 stages in
different scenarios:

14. Breaking bad news video

15. References
● 1- https://www.google.com/search?q=+important+breaking+bad+news&tbm=isch&ved=2ahUKEwjT-fuiqo7wAhVMrhoKHRtfC68Q2-
cCegQIABAA&oq=+important+breaking+bad+news&gs_lcp=CgNpbWcQAzoECAAQQzoCCAA6CAgAEAcQBRAeOggIABAIEAcQHlD7mSJY8dIiYM3ZImgAcAB4AIABggKIAbYTkgEGMC4xLjEwmAEAoAEBqgELZ
3dzLXdpei1pbWfAAQE&sclient=img&ei=PJN_YNPrAszcapu-rfgK&bih=640&biw=1200&safe=strict#imgrc=CXb8MiYdtl9kBM
● 2- https://www.google.com/search?q=why+is+it+imprtant+to+learn+to+break+bad+news&oq=why+is+it++imprtant+to+learn+to+break+bad+news&aqs=chrome..69i57j33.80592j0j15&sourceid=chrome&ie=UTF-8
● 3-
https://www.google.com/search?q=how+to+break+bad+news&safe=strict&sxsrf=ALeKk02ZXL_UFyhm9VOsAQHkzCYj7cAw1A%3A1618972380212&ei=3I5_YLCwDNyIjLsPl5aikAE&oq=how+to+break+bad+new
s&gs_lcp=Cgdnd3Mtd2l6EAEYADICCAAyAggAMgIIADICCAAyAggAMgIIADICCAAyAggAMgIIADICCAA6BggAEAcQHlCOqQNY_NIDYMroA2gAcAF4AIABmgOIAd8MkgEHMi0yLjIuMZgBAKABAaoBB2d3cy13aXr
AAQE&sclient=gws-wi
● 4-
https://www.google.com/search?q=how+to+break+bad+news&safe=strict&sxsrf=ALeKk02ZXL_UFyhm9VOsAQHkzCYj7cAw1A%3A1618972380212&ei=3I5_YLCwDNyIjLsPl5aikAE&oq=how+to+break+bad+new
s&gs_lcp=Cgdnd3Mtd2l6EAEYADICCAAyAggAMgIIADICCAAyAggAMgIIADICCAAyAggAMgIIADICCAA6BggAEAcQHlCOqQNY_NIDYMroA2gAcAF4AIABmgOIAd8MkgEHMi0yLjIuMZgBAKABAaoBB2d3cy13aXr
AAQE&sclient=gws-wiz

16. Thanks