The health practitioners’ profession is aimed towards achieving a universal goal; delivery of high quality health care services to patients. It goes without saying that their occupation involves a lot of communication with both the patients and family members. Nonetheless, most health workers have little or no training on effective communication skills. That explains why an alarming number of patients and family members are not contented with the manner in which information is delivered to them, especially bad news. With that in mind, Kenya Hospices and Palliative Care Association (KEHPCA) officials have decided not to sit and watch as that trend deteriorates. The Director of Programs and Advocacy Officer at KEHPCA, Dr. Asaph Kinyanjui and Mr. David Musyoki respectively have been on the front line in advocating for effective communication in hospitals. On Wednesday 31st May 2017, they travelled to Machakos Level 5 Hospital with one objective; to train health workers on how to effectively break bad news.
“No single formula can make bad news sound like good news. Nevertheless, the manner in which we communicate can be improved,” stated David Musyoki while making his presentation to the participants. He put an emphasis on the fact that sugarcoating is not acceptable in breaking such news; it is about saying the news as it is. However, did you know that you can still say the news as it is without causing too much shock to the patients and family members? Yes, that is possible. You see, you only need to master three approaches of breaking bad news; WPC Chunk method, SPIKES and ABCDE approach.
WPC chunk method of breaking news advocates firing warning shots, pausing and then presenting information. SPIKES approach involves setting up, perception, invitation, knowledge, emotions, strategy and summary. Finally, ABCDE involves advance preparation, building a therapeutic relationship, communicating well, dealing with patient and family reactions and encouraging/validating emotions. One can never go wrong when adhering to the guidelines outlined in these approaches.
You will realize that protocol is part and parcel of breaking bad news. One should prepare the information and ensure that all facts are right. In addition, one should identify a suitable location and ensure that news breaking is done in the right setting. Ladies and gentlemen, this is not an accidental task. It is not something done on the hospital corridors. It involves thorough preparations.
Those sharing information should first assess what the patient and family members already know. They should then fire the warning shots because they actually prepare the patient and family members psychologically. After firing the shots, one should pause a bit to give them time to internalize what you are about to say. The next step is sharing the news. It should be presented in a language that the patient or relatives understand. At no given time should the health workers use jargon while communicating to them. In fact, using vernacular language is highly encouraged so as to avoid misunderstandings.
Breaking bad news is not easy and never will it be, even so, those doing it should be compassionate and should always be ready to respond to the patient’s or relatives’ emotions. They should negotiate a follow-up so as to find out how the patient and family members are fairing on.
At the end of this educative session, Mr. Musau who is in charge of the Machakos Hospital Palliative Care Unit, pledged his support in ensuring that the way health workers communicate to patients will drastically improve. He encouraged nurses and doctors to work as a team so as to make communication more efficient.