Senior man at table looking sad with head down

How to deliver bad news

By Clint McLean

In a field like hearing care, giving bad news comes with the territory. But that doesn’t mean it’s ever easy. One way to become more comfortable delivering bad news is through training. As with most skills, having a method to guide you can alleviate apprehension and improve results. It’s like having a map to direct you in unfamiliar territory.

The SPIKES protocol is one such system. SPIKES is a six-step process with four objectives: Gathering information, Transmitting medical information, Providing support, and Collaborating with the client on treatment. The six steps below support these goals.

Find a quiet, private space where you can speak uninterrupted. Involve a loved one when feasible.

Learn what the patient knows or believes about the condition and listen to their thoughts around it.

Ask permission to give your client information about the condition but be prepared to accept their right not to know. Offer to answers questions later if your client prefers time to digest the news.

Give medical facts about the condition using language that is easily understood and void of jargon. Tell them any positive things first (it is not as bad as feared, for example) and chunk information so it is more easily remembered. Confirm your client understands what you tell them.

Identify and name the emotion, show understanding and respect to your client’s entitlement to their feelings. Identify the source of the emotion and let them know you recognize the connection between the emotion and the cause.

Close the appointment and ask if your client has any further questions. Tell about the purpose and agenda of the next appointment or next step.

The SPIKES protocol helps you share bad news in a way that makes it less distressful to you, the clinician. But more importantly, using SPIKES helps your clients. SPIKES uses techniques to address the emotional reactions of your clients. And, as multiple studies have concluded, providers who struggle to deliver bad news risk greater client dissatisfaction and poorer outcomes.

Whether you are interested in SPIKES for you or for your clients, you can learn more about it in our Inspired by Ida program. The included course, Applying PCC in the appointment, delves more deeply into the SPIKES protocol and includes other great communication frameworks like the Four Habits.

Find Inspired by Ida free in the Ida Learning Hall.