IMPACT OF BAD NEWS COMMUNICATION BY HEALTH PROFESSIONALS IN REFERENCE SERVICES: AN EXPERIENCE REPORT

Abstract

The dreaded “bad news” has a drastic impact on the experience of its listener, due to the potentially negative repercussions it causes. Precisely because of its sensitive content, the way it is transmitted requires efficiency and empathy – values ​​that are rarely present in the practice of health professionals. The objective of the report is to demonstrate the importance of following a protocol for communicating bad news, in order to build a welcoming professional-patient relationship in contrast to what is currently observed. This report was obtained through the experiences of six students at the end of their medical degree, evidencing a serious failure in communication in reference health services. It is worth highlighting the case, in which it was necessary to disclose the diagnosis of penile cancer. Moments before the communication, the patient had reported suicidal ideation in case it was necessary to amputate the member. The phrase “We’re going to have to cut off half of that penis. It’s cancer, did you know?” highlighted the lack of preparation and empathy that occurs even in university services responsible for educating new generations of professionals. The breakdown of the relationship can, therefore, frustrate the understanding of the patient’s expectations regarding the treatment or fail to involve him/her in its planning. It can also generate communication failures, such as a lack of understanding about the prognosis or purpose of the treatment. In this scenario, the communication of bad news is optimized with a staggered procedure, such as the “SPIKES” tool. The acronym in which “S” includes making the patient comfortable; “P”, asking open-ended questions to understand his/her perception; “I”, understanding how much he/she wants to know; “K”, communicating the news; “E” welcoming emotions with empathy; “S” discussing the treatment plan with the patient. Finally, it is necessary to familiarize health professionals with specific protocols such as “SPIKES”, aiming to improve the patient’s experience with the illness, not leaving them helpless as in the example discussed.