SPIKES: EFFECTIVE COMMUNICATION
SPIKES: 6 STEPS TO COMMUNICATE EFFECTIVELY Use with patients, families, colleagues, your family & friends. Use a professional translator whenever necessary. GOAL: UNDERSTANDING the information 1. S ETTING ‒Private. Be prepared. Sit down. Have tissues, water. 2. P ERCEPTION ( A SK)‒ What do they know? “What do you understand?” “What have the doctors told you?” Correct any misperceptions. 3. I NVITATION ‒What do they want to know? Planners want details. “Do you like to have all the facts?” Worriers want reassurance. “Would you prefer I share news with someone else?” 4. K NOWLEDGE ( T ELL) ‒ START WITH A WARNING SHOT‒ “I have some bad news” “Unfortunately, the news is not what you and I hoped for” Pause and watch facial expressions. When you perceive the patient is ready, Tell the news, in short clear phrase, e.g., “Headline” or “Tweet”. Say it, then stop. Simple words (grade 4). No jargon. 5. E MOTION ‒Wait for the response to the news. Use NURSE to Respond to Emotion. May take minutes to days.
6. S UBSEQUENT ( A SK) ‒What do they understand? What questions? Reassure. Can I help you tell your family? When they are ready, plan next steps together.
46 NB: These Reference Cards do not replace careful clinical judgment specific to each patient / family situation. PCIC: Palliative Care Interdisciplinary Curriculum is a collaborative effort of OhioHealth, The Ohio State University Wexner Medical Center, and Nationwide Children’s Hospital in Columbus, Ohio, USA, and other contributors. Permission to reproduce any or all of these PCIC Reference Cards is granted for non-commercial educational purposes only, provided that the attribution statement and copyright are displayed. To reproduce for all other purposes, contact Frank D. Ferris at info@pallmed.us. Copyright © Frank D Ferris 2013-2024. All rights reserved. V14.1, 2024 Adapted from S.P.I.K.E.S. Baile WE, Buckman R, Lenzi R et al. Oncologist 2000. PMID 10964998. And from www.VitalTalk.com. Used with permission.
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