1. Section III: The Interdisciplinary Team and Family Members

2. Healthcare Professionals Influence Communication Outcomes
Behaviors and communication style
Lack of personal experience with death and dying
Fear of not knowing the answer
Lack of understanding patient’s and family’s end-of-life goals
Language barriers

3. Family Meetings Patient may attend Family members
Appropriate clinicians (best to include primary care along with palliative care)
Goal to enhance communication

4. Why are Family Meetings Important?
Share information
Identify needs/fears
Set goals

5. How Do I Articulate the Way Palliative Care Can Help?
Improved clinical care
More efficient use of resources
Better care coordination
Cost avoidance

6. Timing For Conversation is Critical
A good time to talk?
Is there a need to talk?
Has someone else from the interdisciplinary team already spoken with the patient/family?
Is there an “overload” of information?
Is patient experiencing pain/other symptoms?
Caregiver may be exhausted
Dahlin & Wittenberg, 2015

7. Team Communication
Intra-team communication is vital, especially between RN and MD
Should be collaborative
Should be effective and frequent
Document
Expect conflicts

8. When You Have a Team of More Than One, Expect Conflict
Try to take a step back
Identify your own emotions
Define the conflict
Obtain agreement on the conflict
Talk about it
Patient’s best interest should always be foremost
Dahlin & Wittenberg, 2015;
Goulette, 2007; Jeffrey, 2010

9. Communication with Physicians Who Are Unfamiliar with Palliative Care
Honor the relationship physicians have with their patients
Maintain professional relationship
Be specific about the reasons for the “ask.”
“The nurses on the medical unit state that Mrs. James has pain and dyspnea.”
“ Mrs. James’ daughter believes her mother's functional status is declining.”
Palliative care can support the work of attending physicians

10. Communication Vignette: Speaking with Physician Refusing Palliative Care For Patient

11. Summary Communication is complex
The ultimate objective is to advocate for the patient’s wishes
Patients and their families must be involved in communication
Nurse to promote communication among team members, patients and family