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18 Cards in this Set
- Front
- Back
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What are some important facts about telling patients about death
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individualize delivery
people may not remember much of what you say ask What do you know up to this point? |
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What can make bad news worse?
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medical jargon
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What do you say when asked how long do I have to live?
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everyone is individual
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Important tips for giving bad news
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Place and time appropriate
Balance with sensitivity and honesty, but not too blunt |
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SPIKES
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set the stage
perception invitation knowledge explain/empathize summary/strategy |
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SPIKES:
S |
Set the Stage
prepare info, location and setting, know the facts, quiet space, SIT EYE LEVEL, distance and posture should be considered |
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SPIKES:
P |
Patient Perception
Find out what they already know, "make sure we are on same page", what have others told you? When you had your first symptom, what did you think? What is important to the patient/family? |
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SPIKES:
I |
Invitation
Ask how much they want to know or who should be told |
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SPIKES:
K |
Knowledge
Share information "I have some bad news about...." Use language they understand "Do you understand what I have just said?" |
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SPIKES
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Explain/ Empathize
Respond to patient's emotion Empathy acknowledge I can see this isn't something you expected |
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SPIKES:
S2 |
Summarize/Strategy
Negotiate a concrete follow up Let's talk more after..... Develop a short term plan to address immediate concerns Never leave them feeling like they're hanging State what you can do |
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Pitfalls to giving bad news
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failure to assess understanding and emotion, cultural considerations, how it is delivered can affect how the patient adjusts
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When faced with a situation for which there is not curative treatment, we must...
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focus on providing care, supporting the underlying values and meaning of the patient and family
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Palliative care
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Avoid saying "there is nothing more we can do"
Identify dimensions and barriers to QOL Pain and symptom management Ethical, Legal, Cultural considerations |
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Communication
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open ended questions are extremely important
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What should you do when working towards quality care at end of life?
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consider patient and family goals
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The most common form of narcotic abuse in caring for the dying patient
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under treatment of pain
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Nursing tasks
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create environment conductive to communication
Promote doctor-patient communication Promote patient-family communication |
