Chapter 1: Communication essentials

Introduction

Having difficult conversations is likely to be one of your most challenging responsibilities. During a call to a patient with a life-limiting illness or an acute medical emergency in which they can’t be saved, it is not uncommon to be the bearer of news that’s hard for the family to hear. For example: 

  • Telling the patient and family the severity of their illness.

  • Discussing advanced care plans and patient wishes.

  • Recommending someone be transported to a medical facility.

  • Informing the family that death is imminent.

  • Informing the family that death has occurred.


These can be intimidating conversations because:

  • The subject matter is difficult.

  • You may have little time to prepare.

  • The clinical situation may require a hurried conversation. 

  • The location of the conversation may not be ideal.

  • You may not have access to information about previous conversations.

  • Reactions to the news may be very strong.

You’re not alone in your discomfort. Physicians and other health care providers often feel the same way about these difficult conversations. 


For additional information, see Module 6, Supporting the patient and family - Chapter 2, Respecting and responding to cultural practices and traditions.