Breaking bad news in inpatient clinical settings: role of the nurse

Warnock, Clare; Tod, Angela; Foster, Julie; Soreny, Cathy

doi:10.1111/j.1365-2648.2010.05325.x

Cited by 55 publications

(81 citation statements)

References 24 publications

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“…It is of note that SPIKES was designed for doctors by doctors, and most easily translates to the outpatient setting with structured appointments. However other professionals such as nurses and allied health professionals are frequently involved in 9 bad news discussions (Warnock et al, 2010, Griffiths et al, 2015 and despite SPIKES being recommended to nurses as a model of good practice (RCN, 2013) there has been little attempt to evaluate its clinical utility outside of medicine. Warnock et al (2010) remark that, contrary to SPIKES guidance, nurses are frequently unable to prepare for bad news discussions.…”

Section: Nursing Perspectivementioning

confidence: 99%

“…It's also i po ta t to ote that professionals do not always perceive breaking bad news in a negative light. Nurses have described how being involved in breaking bad news has strengthened their relationship with patients (Warnock et al, 2010).…”

Section: Ethosmentioning

confidence: 99%

“…13 Table 2 Implications for practice  Breaking bad news occurs over more than an isolated interview (Warnock et al, 2010)  Breaking bad news guidance need to reflect the clinical reality for professions other than medicine (Warnock, 2010)  Professionals may need additional education on the best way to break bad news when significant others such as family are present (Merckaert et al, 2013)  Breaking bad news guidance should include reference to care and support of the health care professional Gallagher, 2003, Bousquet et al, 2015)  Care must be taken to emphasise a focus on the patient and the patient-professional relationship, athe tha o the task alone (Salander, 2002)  Breaking bad news guidance may need to reflect cultural differences (Rollins and Hauk, 2015)  Well-designed research is needed to elucidate patient outcomes (Paul et al, 2009), including for those living with non-malignant disease…”

Section: Implications For Practice and Future Direction Of Researchmentioning

confidence: 99%

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The use of protocol in breaking bad news: evidence and ethos

Dean¹,

Willis

2016

Int J Palliat Nurs

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This article discusses health professional use of protocol in the breaking of bad news, focussing particularly on the well-known SPIKES framework. The evidence of impact on the patient experience is examined and recommendations are made for further outcome-based research. Existing evidence suggests that the model as commonly interpreted may not fully meet the needs of patients or reflect the clinical experience of breaking bad news for some professionals and further guidance may be needed to support them in their practice. The ethos of the step-wise protocol is debated, questioning whether it helps or hinders individualised care and the formation of a genuine relationship between patient and professional. Finally recommendations for practice are offered.

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Section: Nursing Perspectivementioning

confidence: 99%

Section: Ethosmentioning

confidence: 99%

Section: Implications For Practice and Future Direction Of Researchmentioning

confidence: 99%

See 1 more Smart Citation

The use of protocol in breaking bad news: evidence and ethos

Dean¹,

Willis

2016

Int J Palliat Nurs

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“…It was noticed that predominant in the main authoring medical studies, providing evidence [12], the medical physician often assumes the role of communicating the diagnosis, because they are accountable for the medical treatment decisions. However, communication of a poor diagnosis can also be understood as a process that includes the interactions that occur before, during and after the time when the bad news is reported.…”

Section: Discussionmentioning

confidence: 99%

The Use Of Spikes Protocol In Cancer: An Integrative Review

Sousa¹,

Valenti²,

Hamaji³

et al. 2017

int arch med

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This is a review which aims to evaluate the use of the SPIKES protocol in Oncology. We selected articles written in English published in MED-LINE and CINAHL databases between 2005-2015, with the descriptors defined by the Medical Subject Headings (MeSH): cancer, neoplasms, and the uncontrolled descriptor: SPIKES protocol. Six articles met the inclusion criteria and were fully analyzed; three thematic categories were established: aspects inherent to the health care professional; aspects related to the patient and aspects related to the protocol. The main effects of the SPIKES protocol can strengthen the links between health professionals and patients, and ensure the maintenance and quality of this relationship. The results indicate an important limiting factor for effective doctor-patient relationship; the lack of training provided to medical professionals for the communication of poor diagnoses, verified by the difficulty reported in this moment through interviews in the analyzed studies.

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“…Communicating a diagnosis to patients and relatives is a complex and multi-faceted activity (Warnock et al 2010, Warnock 2014. If done badly it can cause long lasting distress, confusion and resentment' (Fallowfield & Jenkins, 2004).…”

Section: Introductionmentioning

confidence: 99%