Question

using the SPIKES model, show how you should break the news of a patient dying within 24hrs od admission to an individual or group of relatives. (600 words)

Answer 1

Using SPIKES model, it will be convenient for medical staff or team as well as for relatives to deliver the information and for them to perceive it.

It is a new protocol,which has been set for such incidents. It is a 6 step protocol in which all the activities are done, and they start with the first letter as that of spikes i.e;

SETTING UP the Interview (S)

Arrange for some privacy, Involve significant others, Sit down.

Make connection with the patient.

Manage time constraints and interruptions.

PERCEPTION(P)

"What have you been told so far?”

Assess receiver's level of health literacy.

INFORM (I)

Briefly explain chronology of events leading up to death (or bad news)

Avoid euphemisms

Knowledge (K)

Allow receiver to ask questions.

Empathy (E)

Say "I'm sorry."

Repsond and validate the emotions of grieving: NURSE

Name the emotion

"It sounds like this has been overwhelming."

Understand the emotion (empathize)

"I cannot imagine how hard this must be for you."

"I wish I had better news."

Respect the patient or family

"You are asking all of the right questions."

"You are being such a strong advocate for your [family member]."

Support the patient or family

"We will be here for you."

Explore the emotion

"What other things are you worried about?"

"Tell me more about what you're thinking."

Summary and Strategy (S)

Acknowledge questions may arise after processing, establish your availability to be reached by social work in they have questions that come up when they see their loved one.

Leave receiver with social work. "I'm going to step out and let (the social worker) help you with the next steps"

# there is also one more protocol used in place of spike and i.e; GRIEVING protocol