M. Racsa, Florida Hospital Memorial Medical Center, Daytona, FL, United States
One of the core competencies of providing palliative care is the ability to communicate with patients and their families. While many of us think that we are excellent communicators, there is always room for improvement. Communication is a skill and no matter what level you are starting at, there is always room for growth and refinement. Some basic tools are provided in this chapter to help guide you on your journey toward mastery. Your journey will involve trial and error, taking risks (going outside your comfort zone), taking the time to debrief on what went well or not so well, and what improvements you can make.
Palliative care; communication; prognosis
• One of the core competencies of providing palliative care is the ability to communicate with patients and their families [1].
• While many of us think that we are excellent communicators, there is always room for improvement.
• Communication is a skill and no matter what level you are starting at, there is always room for growth and refinement.
• Some basic tools are provided in this chapter to help guide you on your journey toward mastery.
• Your journey will involve trial and error, taking risks (going outside your comfort zone), taking the time to debrief on what went well or not so well, and what improvements you can make.
• One of the simplest but most effective approaches to communicating with a patient is the “ASK-TELL-ASK” method [2].
• It demonstrates willingness to listen to and negotiate the patient’s agenda and builds on the patient’s present knowledge and understanding of his/her illness.
• One of the most challenging aspects of being an oncologist is delivering “bad news.”
• SPIKES is a six-step strategy that provides a useful framework for clinicians [2–4].
• We encourage focusing on improving one step at a time.
• Modify and tailor this approach to what feels most authentic to you and what meets your patient’s specific needs.
• NURSE is a useful guide to respond to patient emotions with empathy [2].
• While it can be tempting to ignore strong emotions, it is important to openly acknowledge and demonstrate empathy when patients are in distress [5].
• Approaching the topic of prognosis with a patient and their family can be challenging.
• ADAPT is a “talking map” to help clinicians navigate through conversations about prognosis [6].
• You have probably conducted several family meetings already whether formally or informally.
• The following approach provides a useful guide to conducting a family meeting [4,9–11].
• Note that an effective meeting includes adequate preparation and debriefing afterward.
• An important component of palliative care is addressing a patient’s spiritual needs and concerns in the context of his/her health care.
• FICA is a useful means of framing the discussion about spirituality with patients and their families [11].
• Even if you do not feel comfortable discussing a patient’s spirituality, take the first step to acknowledge its importance in a patient’s illness and make a referral to social work or clergy.
Faith and belief | |
Importance | |
Community | |
Address |