Module 3: Communicating with Families in Difficult Circumstances


The ANZICS Statement on Care and Decision-Making at the end-of-life for the Critically Ill (2014) recommends that ICU staff involved with dying patients should undertake education in how to communicate effectively with patients and their families around EOL plans. However, research suggests ICU clinicians receive little educational preparation on how to care for patients at EOL, specifically around communication with patients and their families (Beckstrand, Callister, & Kirchhoff, 2006; Brooks, Manias, & Nicholson, 2016; Efstathiou & Clifford, 2011; Festic, Wilson, Gajic, Divertie, & Rabatin, 2012; Fridh, 2014). Implications of poor communication preparation include lack of multidisciplinary collaboration, missed opportunities of conducting EOL discussions with patients due to clinical deterioration, and family distress due to mixed information (Brooks et al., 2016; Noome, Dijkstra, van Leeuwen, & Vloet, 2016). Additionally, poor communication has been shown to result in loss of family trust and low levels of family satisfaction (Efstathiou & Clifford, 2011; Espinosa, Young, Symes, Haile, & Walsh, 2010).

Read chapter 5 of ANZICS Statement on Care and Decision-Making at the End of Life for the Critically Ill.

Think about the last time you witnessed an end-of-life discussion with a family. What was positive about the discussion? What was negative about the discussion? What style of communication was exhibited by the person conducting the discussion? What was the outcome of the discussion?