Conversations in end-of-life care: communication tools for critical care practitioners

Shannon, Sarah E., Long-Sutehall , Tracy and Coombs, Maureen (2011) Conversations in end-of-life care: communication tools for critical care practitioners. Nursing in Critical Care, 16, (3), 124-130. (doi:10.1111/j.1478-5153.2011.00456.x). (PMID:21481114).


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Background: Communication skills are the key for quality end-of-life care including in the critical care setting. While learning general, transferable communication skills, such as therapeutic listening, has been common in nursing education, learning specific communication tools, such as breaking bad news, has been the norm for medical education. Critical care nurses may also benefit from learning communication tools that are more specific to end-of-life care.

Strategy: We conducted a 90-min interactive workshop at a national conference for a group of 78 experienced critical care nurses where we presented three communication tools using short didactics. We utilized theatre style and paired role play simulation. The Ask-Tell-Ask, Tell Me More and Situation-Background-Assessment-Recommendation (SBAR) tools were demonstrated or practiced using a case of a family member who feels that treatment is being withdrawn prematurely for the patient. The audience actively participated in debriefing the role play to maximize learning. The final communication tool, SBAR, was practiced using an approach of pairing with another member of the audience. At the end of the session, a brief evaluation was completed by 59 nurses (80%) of the audience.

Summary: These communication tools offer nurses new strategies for approaching potentially difficult and emotionally charged conversations. A case example illustrated strategies for applying these skills to clinical situations. The three tools assist critical care nurses to move beyond compassionate listening to knowing what to say. Ask-Tell-Ask reminds nurses to carefully assess concerns before imparting information. Tell Me More provides a tool for encouraging dialogue in challenging situations. Finally, SBAR can assist nurses to distill complex and often long conversations into concise and informative reports for colleagues.

Item Type: Article
Digital Object Identifier (DOI): doi:10.1111/j.1478-5153.2011.00456.x
ISSNs: 1362-1017 (print)
1478-5153 (electronic)
Keywords: communication in critical care, critical care nursing, family care in critical care, nurse–patient communication
Subjects: H Social Sciences > HE Transportation and Communications
R Medicine > RA Public aspects of medicine
R Medicine > RT Nursing
Divisions : University Structure - Pre August 2011 > School of Health Sciences
ePrint ID: 184089
Accepted Date and Publication Date:
May 2011Published
Date Deposited: 05 May 2011 08:42
Last Modified: 31 Mar 2016 13:37

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