These free B.Pharm notes on difficult news and emotionally charged situations cover chapter 17 of Healthcare Psychology and Communication Skills, a first-semester subject. Read the key points below, then study the complete chapter PDF. You can browse every chapter in the Healthcare Psychology and Communication Skills category.
Table of Contents
Read the following document for full information
Overview of difficult news and emotionally charged situations
This chapter deals with giving difficult news and handling emotionally charged situations in healthcare. It explains the nature of difficult news, the SPIKES protocol, the use of silence, and how to handle denial, bargaining, anger and medical errors, along with cultural issues and provider resilience.
Key points on difficult news and emotionally charged situations
- Difficult news is any information that sharply changes how a patient or family sees the future and creates a gap between what they expected and what is real.
- In the Knowledge step of SPIKES, a warning shot prepares the patient, plain language is used instead of medicalese, and euphemisms such as growth or shadow are avoided.
- The NURSE framework (Naming, Understanding, Respecting, Supporting, Exploring) guides empathic responses, and false reassurance such as ‘It will be okay’ should be avoided.
- Denial is a defence mechanism that protects the mind from overwhelming pain, so arguing seldom works and the clinician should track the denial and leave the door open.
- Disclosure and apology for a medical error means admitting the mistake, expressing sincere regret, and explaining how harm will be reduced and repeat errors prevented.
Relevance to pharmacy practice
Pharmacists may have to explain a serious illness, a failed treatment or a medicine error to upset patients and families. Knowing how to deliver news with empathy, handle anger and look after their own well-being helps them keep the patient’s trust.
Every chapter in this subject builds on the one before it, so do not skip topics that look simple. Definitions, classifications and examples are the parts that examiners return to most often, and a clear understanding here will also make later subjects easier to follow in the coming semesters.
Frequently asked questions on difficult news and emotionally charged situations
What is the SPIKES protocol?
SPIKES is a structured roadmap for giving difficult news. Its steps are Setting, Perception, Invitation, Knowledge, Emotions with empathy, and Strategy and Summary. It is both a checklist and a philosophy of care.
How should a clinician deal with an angry patient?
First ensure safety, then keep a non-threatening posture with open hands and a low voice, and listen actively. Accept the feeling without accepting the aggression, and move from ‘me versus you’ to ‘us versus the problem’.
What is a second victim in healthcare?
A second victim is a provider who is traumatised after being involved in an adverse event or error. Debriefing, peer support and talking with colleagues help the provider recover and stay present for patients.
Quick revision checklist
Use this self-test after reading the chapter on difficult news and emotionally charged situations. If you can do all of the following without looking at your notes, you are ready for the exam.
- I can explain: what difficult news means
- I can explain: the steps of the SPIKES protocol
- I can explain: how to handle denial and anger
- I can explain: disclosure and apology for errors
- I can explain: the second victim phenomenon
Study and exam tips
Start by reading the chapter once for the overall idea, then revise difficult news and emotionally charged situations using headings, definitions, classifications and examples. Short-answer questions in the university exam usually ask for definitions, features, advantages, disadvantages and examples, so write these in your own words and practise drawing the tables and flow charts that the chapter has.
For wider reading, standard textbooks and open resources such as the NCBI Bookshelf help you confirm terms and see more examples. Revise difficult news and emotionally charged situations again a day later and again a week later, because spaced revision improves long-term memory.
This page is part of the Healthcare Psychology and Communication Skills series for first-semester B.Pharm students on B.Pharm Guru, where every chapter has a short summary and a full PDF. Bookmark this page and share it with classmates who are preparing for the same exam.
Related notes: 19. WRITING PATIENT RECORDS, REPORTS AND DISCHARGE SUMMARIES, 20. USE OF TECHNOLOGY AND DIGITAL COMMUNICATION TOOLS IN HEALTHCARE SERVICES.
Previous: 16. COMMUNICATION WITH PATIENTS, CAREGIVERS AND INTERDISCIPLINARY TEAMS. Next: 18. LEGAL AND ETHICAL ISSUES IN HEALTH COMMUNICATION – CONFIDENTIALITY AND CONSENT. Back to the Healthcare Psychology and Communication Skills category.
