SUNBURN: a protocol for delivering bad news in trauma and acute care surgery

INTRODUCTION: The delivery of bad news can be one of the most challenging tasks in surgery. There are numerous barriers specific to trauma and acute care surgery (TRACS) that make these conversations more difficult. Prior protocols have all been designed for oncology and primary care with poorer application to TRACS. The lack of guidance for leading these conversations in TRACS led us to develop the SUNBURN protocol. It draws elements from prior protocols and discards the irrelevant aspects and pays particular attention to the TRACS-specific concerns. SUNBURN PROTOCOL: Step 1: S–Set Up; Step 2: U–Understand Perceptions; Step 3: N–Notify (‘Warning Shot’); Step 4: B–Brief Narrative and Break Bad News; Step 5: U–Understand Emotions; Step 6: R–Respond; Step 7: N–Next Steps. CONCLUSION: This protocol can provide a framework to help guide and ease the delivery of bad news in TRACS.