Comms Lab: Episode 41
Breaking Bad News: The Hardest Conversation of All
What’s the hardest conversation of all? For many of us, it’s breaking bad news. Having to tell someone they have a serious disease, or informing someone that their loved one has died…
These are some of the toughest things to do. And the stakes are high. The person receiving the news will likely remember this moment for the rest of their life. That’s why knowing how to do this well is so important.
In this video, I run through the SPIKES framework for breaking bad news, take a look at the evidence that supports it, and provide examples of the kinds of words and phrases you might use.
Got feedback for me? Great! I’m always trying to make my videos better and more relevant. Let me know what you think in the comments section, or anonymously via jotform
S – SETTING
P – PERCEPTION
I – INVITATION
K – KNOWLEDGE
E – EMOTION
S – STRATEGY
S – SET UP
U – UNDERSTAND PERCEPTIONS
N – NOTIFY, the Warning Shot
B – BRIEF NARRATIVE and Break Bad News
U – UNDERSTAND EMOTIONS
R – RESPOND
N – NEXT STEPS
0:00 – Breaking Bad News
1:05 – Why is it important?
2:21– Sequencing Really Matters
3:02 – Setting
4:34 – Perception
5:34 – Invitation
7:12 – Knowledge
9:10 – Emotion
11:22 – Strategy
13:21 – One Last Important Tip…
- Richards H. De-escalating Challenging Emotions in Others – A Battle-Tested Approach. 2022
- Richards H. The Commonest Mistake in Responding to Emotion. 2022
- Richards H. 5 Skills for Validating Other’s Emotion to Access Their Best Self. 2022
- Nickson C. Breaking Bad News to Patients and Relatives. LITFL
- Dr Rob Buckman. Breaking Bad News. 99% Invisible Podcast: Breaking Bad News
- Rabow MW, McPhee SJ. Beyond breaking bad news: how to help patients who suffer. West J Med. 1999 Oct;171(4):260-3.
- Baile WF, Buckman R, Lenzi R, Glober G, Beale EA, Kudelka AP. SPIKES-A six-step protocol for delivering bad news: application to the patient with cancer. Oncologist. 2000;5(4):302-11.
- Fallowfield L, Jenkins V. Communicating sad, bad, and difficult news in medicine. Lancet. 2004 Jan 24;363(9405):312-9.
- Seifart C, Hofmann M, Bär T, Riera Knorrenschild J, Seifart U, Rief W. Breaking bad news-what patients want and what they get: evaluating the SPIKES protocol in Germany. Ann Oncol. 2014 Mar;25(3):707-711.
- Velez D, Geberding A, Ahmeti M. SUNBURN: a protocol for delivering bad news in trauma and acute care surgery. Trauma Surg Acute Care Open. 2022 Feb 9;7(1):e000851.
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Hayden is an emergency physician at University Hospital Geelong and a senior lecturer at Deakin University, Geelong. He is somewhat obsessed with the science and art of effective communication, and in particular: difficult conversations. He believes that we can all get better at having difficult conversations, and that the process of learning to do so can be seriously fun.
Hayden is also an avid but terrible surfer, ad hoc gardener, and dad to two awesome kids.