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Nurse Approach to SPIKES – A Six-Step Protocol for Delivering Bad News

Nurse Approach to SPIKES – A Six-Step Protocol for Delivering Bad News

When there is a bad news about a patient’s health to be delivered most patients reported they prefer this news to be delivered by their nurse rather than by their physician.

Nurses are found to have a higher level of compassion and a better rapport with the chronically ill patient. Physician shortage and a more prominent role of nurses in palliative care are increasing the need to develop a standard bad news communication protocol implemented in nursing.

We recommend the SPIKES protocol for communicating bad news to patients. This is subdivided in six steps to facilitate the communication.

  1. Setting up this is preparing the setting by learning the current patient perception of the whole situation. In this setting the open-ended question are the best to start e.g. Have you been told anything about your medical condition?
  2. Assessing the patient’s perception. Let the patient express his understanding of the medical condition and possible outcomes. E.G. Tell me what do you understand at this point. Alternatively, what do you know about your medical condition?
  3. Invitation. Request the patient permission to proceed or his invitation to discuss further the matter. Do you want to talk about your medical condition? On the other hand, are you ready to discuss your medical condition?
  4. Knowledge and information. During this part you share knowledge and give the most accurate information in layman terms of the patient’s health.
  5. Emotion. Responding to patient emotion with empathy, you need to give some time to patient to collect themselves. You should be silent for 10 to 20 seconds while the patient is too upset to talk.
  6. Strategy and Summary. Let them know their plan of care and the next steps for their medical attention. Indicate how the patient or their family can reach you to answer all future questions. Evaluate if the patient is in good condition to leave the center.

Nurses are in permanent contact with patients and their families. They develop a long lasting relation of trust and support with them. Nurse education around the world is increasing the nurse-leading role. It required being well prepared on how to handle the bad news communication. The Skilled Nurse International offers tools to improve the communication skill and help the patient coping with the bad news.

Online Nursing Education is a good source to get these skills. We have many courses with real life scenarios that show the best communicational strategies. The ability to get access to Online Nursing CPD 24 hours a day 7 days a week makes learning easy.

Try one of our courses today http://www.theskillednurseinternational.asia/our-courses/

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