Abstract
Communication skills are paramount in effective delivery of palliative care. The emphasis in much of the previous literature has been on physician communication and also has been largely focused on the singular topic of breaking bad news. Much less emphasis has been placed on communication as a vital skill of nurses and on the opportunities for nurses, as they are often the key professionals at the bedside after "bad news" is shared. The study was conducted as a survey of nurses (N = 333) attending an End-of-Life Nursing Education Consortium conference. The survey assessed nurses' perspectives of the most challenging aspects of communication in their work and elicited examples of both positive and negative communication. Results of the survey indicate important areas for future research and education to enhance nurses' abilities to communicate effectively and compassionately. Respondents identified several key areas in need of improvement related to communication. Examples of the most difficult areas of communication include discussing bad news, talking with physicians about palliative care issues, discussing spiritual concerns, and talking with patients/families from different cultures. Nurses are the primary, constant healthcare providers across clinical settings, and effective skills in communication are critical to nursing practice and to ensure quality care. Education regarding communication skills is needed in basic and graduate nursing education programs as well as in continuing education for practicing nurses.