Breaking Bad News

 Prepare emotionally.
ALSANGEDY
 Ask for supportive persons BULLETS

present.

Ask what the patient or

FOR PACES
FOR EASY PASSING PACES FROM
family already knows
THR 1ST ATTEMPT
and understands.
Dr. Ibrahim Alsangedy
 Find out the patient's MRCP-UK
expectations before you MRCPE
give the information.
 Speak frankly but
compassionately.
 Use the words cancer or
death.
 Allow silence and tears
 no interruptions.

 Be attuned to body
language.
ALSANGEDY BULLETS FOR PACES

 Be empathetic; it is
appropriate to say “I'm
sorry”
 Discuss treatment
options
 Address patient
concerns.
SPIKES—Six-Step Protocol 5 Key Mistakes When
for Breaking Bad News Delivering Bad News
ALSANGEDY BULLETS FOR PACES
 S—SETTING UP the Interview  Bargaining: - allow the
 P—Assessing the Patient's conversation to become a
PERCEPTION isangedy@gmail.com negotiation and staying away
 I—Obtaining the Patient's 00965 69691034 from your main message.
INVITATION
 K—Giving KNOWLEDGE and
Facebook page: - MRCP PACES  Cushioning: - softening the
Information to the Patient from the 1st attempt message so much that the patient
 E—Addressing the Patient's Facebook group: - MRCP PACES does not even understand that
EMOTIONS with Empathic you are giving him bad news
from the 1st attempt
Responses
 S—STRATEGY and SUMMARY  Unloading: - deliver the
message in a hurried, panicked
way – freeing yourself of the
emotional burden you had been
Do not forget to carrying and unloading it onto the
 Introduce yourself patient.

 Confirm patient name or relative  Arguing: - You need to control

name and relation yourself in a way that diffuses a
potential conflict
 Obtain Acceptance for discussion
the issue  Mechanizing:- You go “robotic,”
delivering the message in a
 Discuss social history and stilted, awkward style
address any social problems

 Address patient concerns

 Show sympathy and empathy all

through the discussion