Page 28 - Palliative Care, Trials and COVID-19 Tribulations: First-hand experience shared by the experts at ground zero

Breaking Bad News Using SPIKES

Just a bit about breaking bad news. We commonly use a protocol called the SPIKES protocol.
It is a six-step protocol. So, you can remind yourself, when you start out, always prepare
yourself, make sure you know all the details of the case, introduce yourself and your role in
the patient’s care.

We should always ensure that the person you are talking to is in a safe place, and you are not
calling them while they are driving a car. Then, check what the patient knows, then explain
why you are calling them, and fire a warning shot if you are going to give bad news. Then,
provide the information without using any medical jargon. Be very clear and direct. Most
importantly, acknowledge their feelings and validate their emotions, showing empathy.
Finally, you can clarify whatever questions they may have and also tell them when to expect
another update.

Figure 17: The protocol used when breaking bad news to the family of the patients.

Empathy

I just want to highlight something about empathy. I think this is really an important thing to
think about when we are facing this kind of situation. Many patients with severe COVID-19
have passed on, they are isolated from their families. Even towards their funeral, they have to
stay at a distance. So, just try and imagine how you would feel, if you are not able to be with
someone that you truly love, especially in their last moments? What are some of the things
that you might wonder.

Was he comfortable?