The document provides guidance on effectively delivering bad news to patients. It defines bad news as information that seriously impacts one's view of the future. Examples include terminal illnesses like cancer or Alzheimer's disease. The document recommends using the SPIKES protocol to structure difficult conversations. SPIKES stands for setting up the conversation in a private setting, understanding the patient's perception, obtaining permission to share details, providing knowledge of the diagnosis in small portions with empathy, and summarizing the discussion while checking for understanding.

1. Ms Nisha Mathew

2. It is AS difficult for a person
to convey the bad news, as a
person who listens it

3. What is Bad News?......
Any information which adversely and seriously
affects an individual's view of his or her future;
whether news is bad or not can only be in the
eye of the beholder.

4. Like?.....
A Health condition that can be
physical as well as mental disorder.
o Diagnosis of a terminal illness like Cancer, AIDS.
o Mental disorder : Downs syndrome
o Degenerative disorder: Alzheimer's disease

5. How to break the Bad News!!!
S-P-I-K-E-S

6. Not that one But SPIKES
means
 S- Setting Up
 P- Perception
 I- Invitation
 K- Knowledge
 E- Empathy
 S- Strategize & summarize

7. Setting
 Arrange for a private setting
 Involve Significant others
 Sit down
 Communicate that you are listening, using silence and
repetition
 Remain available for the duration of the meeting

8. Perception
 Identify what the patient & family understand
 Use the same vocabulary that they do

9. Invitation
 Obtain permission for the depth & breadth of
information

10. Knowledge
 Provide warning that Bad News is going to be shared
 Avoid technical language
 Give the information in small chunks
 Tailor the rate at which information is shared

11. Empathy
 Listen for and identify the emotion (or mix of
emotions)
 Identify the source or cause of the emotion.

13. Strategy & Summary
 Check for
Understanding
 Summarize the
discussion
 Reiterate the pain

14. Bibliography
Textbook of Medical-Surgical Nursing,
Brunner & Suddarth, Twelfth edition ,
Volume-1 , page No- 405