We regularly have difficult conversations in critical care. We deal with sick and complex patients who may be at the end of life. The families we talk to may be in a state of shock and acute grief, unable to think clearly and make important decisions. Moreover, patient safety incidents and other challenging issues such as organ and tissue donation may further complicate the patient journey. In this talk by Jon Gatward, we follow the story of Leah and the difficult conversations that were needed in caring for her and her family. Jon examines some of the key elements that can contribute to successful communication in difficult circumstances such as: • Having a plan and a structure before embarking on these difficult conversations. • Working towards a common agenda and ensuring that everyone feels safe and able to ask questions. • Showing empathy and using silence well, allowing people the space and time to process information. • Giving people the benefit of the doubt, after all, these are their family members that we are talking about. As clinicians, our training in this type of communication may be limited to observing our mentors, and we may feel inadequately prepared. We will investigate how simulation training can be used to improve the quality of communication, increase our skill and comfort level so that we can guide patients and families through complex and challenging situations. We will also investigate how lessons learnt from simulation debriefing can be transferred to the conduct of difficult conversations in real life. Most importantly – we need to ensure that we look out for ourselves and for our colleagues. These conversations are draining and difficult. Tune in to a DAS SMACC talk by Jon Gatward on Critical Moments in the Intensive Care Unit.
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