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ABCDE Model Of Breaking Bad News

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1.1 ABCDE Model of Breaking Bad News

Rabow and McPhee developed a practical and comprehensive model, synthesized from multiple sources, that utilizes the simple mnemonic ABCDE(Rabow MW, McPhee SJ, 1999). The following recommendations are patterned after Rabow and McPhee 's ABCDE mnemonic, with modification and additional material from other sources. Specific situations may preclude carrying out many of these suggestions, the recommendations are intended to accommodate as a general guide and should not be viewed as extravagantly prescriptive. Below are the steps inside the model:

A – Advance Preparation The first step of this model is for clinicians to familiarize themself with the relevant clinical information. Ideally, have the patient
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When possible, have family members or other close persons present and this should be at the patient 's discretion. If bad news is anticipated, the best is to ask in advance who they would want to present and how they would wish the others to be involved. Starting the conversation by introducing yourself to everyone present and ask for names and relationships to the patient. Foreshadow the bad news, “I 'm sorry, but I have bad news.” Physical touch must be used where appropriately because some patients or family members will prefer not to be physically contacted. Not to forget be sensitive to cultural differences and personal predilection. Avoid inappropriate humor or flippant comments; depending on your relationship with the patient, some discreet humor may be congruous. Assure the patient you will be available. Schedule follow-up meetings and make congruous arrangements with your office. Advise staff and colleagues of the…show more content…
Even if a remedy is not authentic, offer hope and encouragement about what options are available. Always discuss treatment options at the outset, and arrange follow-up meetings for decision making. Not to forget to explore what the news denotes to the patient. Inquire about the patient 's emotional and spiritual needs and what patient support systems they have in place and offer referrals as needed. Utilize interdisciplinary service to enhance patient care for example hospice, but avoid utilizing these as mean of disengaging from the relationship. Attend to your own needs during and following the distribution of bad news and issues of counter-transference may arise, triggering poorly understood but powerful feelings. A formal or informal debriefing session with involved house staff, office or hospital personnel may be opportune to review the medical management and
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