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delivering difficult news to a veteran is never easy especially in matters of life and death many providers may not have been taught how to handle these delicate conversations this training demonstrates how to deliver difficult information accurately with compassion we recommend using an approach that follows the acronym spikes which stands for setting perception invitation knowledge empathy and strategy research has shown the providers feel more confident and patients feel more supported when using the spikes approach in this program you will watch a physician use the spikes protocol with a veteran nearing the end of her life after watching this video you should be able to describe the spikes protocol and to apply to your practice make sure you also view our other video that apply spikes to delivering the diagnosis of Alzheimers disease by using spikes we can communicate better and provide compassionate care to veterans mom you warm enough its been one year since 74 year old veteran