Delivering Bad News: Step Two (Professional Track)

STEP TWO: CONVERSATION WITH OTHERS                                               30 min.

ACT AGREEMENTS AND DIALOGUE

Trust the power of collective wisdom as you engage with others‒ using the lessons from the video as a jumping board for sharing.  Focus on the questions that can best support your role and experience as caregiver.

Courageous Conversations Series
Lesson One: Delivering Bad News

ACT Step Two

1. “It’s actually physiologically easier to lie than to tell the truth.” – Soul & Science Lesson

2. “Bad news is always . . . in the ‘eye of the beholder,’ such that one cannot estimate the impact of the bad news until one has first determined the recipient's expectations or understanding. (“SPIKES—A Six-Step Protocol for Delivering Bad News: Application to the Patient with Cancer” 2000)

Six Step SPIKES Protocol for Delivering Bad News

S-Setting
P-Patient Perception
I-Invitation
K-Knowledge
E-Emotions
S-Strategy & Summary

3.“ . . . breaking bad news is also a complex communication task. In addition to the verbal component of actually giving the bad news, it also requires other skills. These include responding to patients' emotional reactions, involving the patient in decision-making, dealing with the stress created by patients' expectations for cure, the involvement of multiple family members, and the dilemma of how to give hope when the situation is bleak. The complexity of the interaction can sometimes create serious miscommunications such as patient misunderstanding about the prognosis of the illness or purpose of care. - (“SPIKES—A Six-Step Protocol for Delivering Bad News: Application to the Patient with Cancer” 2000)

4. “Although it may seem contradictory, hoping for the best while at the same time preparing for the worst is a useful strategy for approaching patients with potentially life-limiting illness. By acknowledging all the possible outcomes, patients and their physicians can expand their medical focus to include disease modifying and symptomatic treatments and attend to underlying psychological, spiritual, and existential issues. (“Hope for the Best, and Prepare for the Worst” 2003)

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