Keywords

communication training, goals-of-care discussions, interprofessional approach, palliative approach to care, palliative care nursing, person-centered care, serious illness communication, serious illness conversations, Serious Illness Conversation Guide

Authors

1. Beddard-Huber, Elizabeth MSN, RN, CHPCN(c)
2. Strachan, Patricia PhD, RN
3. Brown, Susan MScN, BScN, RN, GNC(c)
4. Kennedy, Vicki MN, BN, RN, CRE, CHPCN(c)
5. Marles, Maria Mia MSN, RN
6. Park, Sungyou MSN, RN
7. Roberts, Della MSN, RN, CHPCN(c)

Abstract

Communication is vital to quality palliative care nursing particularly when caring for someone with a chronic life-limiting illness and their family. Conversations about future decline and preferred care are considered challenging and difficult and are often avoided, resulting in missed opportunities for improving care. To support more, earlier, better conversations, health care organizations in British Columbia, Canada, adopted the Serious Illness Care Program inclusive of the Serious Illness Conversation Guide developed by Ariadne Labs. Workshops for interprofessional team members have been held throughout the province. Nurses and allied health identified the need for more guidance in using the guide in the contexts of their clinical practice. Specifically challenging has been prognosis communication that falls within the scope of practice for each profession. Informed by workshop feedback, an expert team of nurse clinicians and educators tailored an interprofessional clinician reference guide to optimize the guide's use across health care settings. In this article, we present the adaptations focusing on (1) the role of nurses and allied health in serious illness communication, (2) prognosis communication, and (3) a range of role-play scenarios specific to nonphysician practice for serious illness conversations that may arise within the process of care.