How can you communicate effectively during difficult patient conversations?

As a healthcare professional, you may face situations where you need to communicate difficult or sensitive information to your patients, such as a diagnosis, prognosis, treatment options, or end-of-life care. These conversations can be challenging, emotional, and stressful for both you and your patients. How can you communicate effectively during difficult patient conversations and provide compassionate and respectful care? Here are some tips to help you.

1 Prepare yourself

Before you initiate a difficult conversation, take some time to prepare yourself mentally and emotionally. Think about the purpose, goals, and possible outcomes of the conversation. Anticipate the questions, concerns, or emotions that your patient may have. Review the relevant medical information and evidence. Plan how you will structure the conversation and what language you will use. Avoid jargon, euphemisms, or vague terms that may confuse or mislead your patient. Also, consider your own feelings and biases and how they may affect your communication. Seek support from your colleagues or supervisors if you need it.

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2 Establish rapport

The first step in any difficult conversation is to establish rapport and trust with your patient. Greet them by name, introduce yourself and your role, and explain the reason for the conversation. Use a warm, empathetic, and respectful tone and maintain eye contact and open body language. Show interest in your patient as a person, not just as a case. Ask them about their preferences, values, and goals. Listen actively and attentively to their responses and acknowledge their feelings. Avoid interrupting, judging, or dismissing their views. Validate their emotions and concerns and express your support and compassion.

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Yvette Den-Drijver

Director of Compliance | A Master in Project Management | IPPC experience | PC site delivery | SMSTS | ISO standards solution provider
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In my experience, most conversations during emotional stressful situations tend to fall on deaf ears, without intention or need. Our ability to hold in information during difficult times is almost impossible, even when information has been heard, it is understood and uncompressed differently to other times. I would ensure the patient is getting time to process the information, be patience in deliverance, with some slight personal contact. We are human but that is makes us special, we are all different in our acceptance of circumstances, so every delivery and timespan is individual and personal for the time, place and environment. Above all read the room, read the person and be kind.

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3 Deliver the information

The next step is to deliver the information in a clear, honest, and sensitive way. Ask your patient how much they already know and how much they want to know. Respect their right to information and autonomy, but also their right to decline or defer information if they are not ready. Use the ask-tell-ask method to check their understanding and elicit feedback. Ask them what they know or expect, tell them the information in a concise and simple way, and ask them what they understood or how they feel. Repeat or clarify the information if needed and address any misconceptions or gaps.

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Todd Burch

President & CEO | Hospitals & Healthcare FinTech
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This reminded of a specific conversation with an inpatient who had referred to a nurse in a manner that was racially derogatory. In that situation it required a very direct communication style that this type of behavior and language would not be tolerated. It was a cordial conversation, but one that left no doubt about the expectation.

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4 Explore options

After delivering the information, you need to explore the options and implications with your patient. Depending on the situation, this may involve discussing the benefits, risks, and alternatives of different treatment plans, the goals and expectations of care, the possible outcomes and scenarios, or the legal and ethical issues involved. Invite your patient to ask questions, share their opinions, and express their preferences. Provide them with relevant and reliable resources or referrals if they want more information. Encourage them to involve their family, friends, or other support people if they wish. Help them weigh the pros and cons of each option and guide them towards a decision that aligns with their values and goals.

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5 Negotiate a plan

Once you have explored the options with your patient, you need to negotiate a plan of action and follow-up. Summarize the main points of the conversation and confirm the decision or agreement that you and your patient have reached. Explain the next steps, such as what tests, treatments, or referrals will be done, when and how they will be done, and what the expected outcomes are. Ask your patient if they have any concerns or questions about the plan and address them. Document the plan and the consent in the medical record and inform other relevant health professionals. Arrange a time and mode of communication for the follow-up and review.

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6 Close the conversation

The final step is to close the conversation in a positive and respectful way. Thank your patient for their time, participation, and trust. Express your empathy, support, and hope. Reassure them that you will continue to provide them with quality care and that they can contact you or your team if they have any issues or questions. Ask them if they need anything else or if there is anything else you can do for them. End the conversation with a friendly farewell and a smile.

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7 Here’s what else to consider

This is a space to share examples, stories, or insights that don’t fit into any of the previous sections. What else would you like to add?

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Udaykumar Vegad

Assistant Professor at Graduate School of Pharmacy, GTU
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The most important character of the conversation is the intention/motivation of the communication. The counselor should be motivated enough to deal with difficult situations with perseverance. The innate qualities and self control should be achieve to help you deal with disturbed mental conditions and environments created during dialogues.

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How can you communicate effectively during difficult patient conversations?

1

2

3

4

5

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1 Prepare yourself

2 Establish rapport

3 Deliver the information

4 Explore options

5 Negotiate a plan

6 Close the conversation

7 Here’s what else to consider

Communication

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How can you communicate effectively during difficult patient conversations?

1

2

3

4

5

6

7

1 Prepare yourself

2 Establish rapport

3 Deliver the information

4 Explore options

5 Negotiate a plan

6 Close the conversation

7 Here’s what else to consider

Communication

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