Clinician-family communication in the neonatal intensive care unit (NICU) can be particularly difficult, especially when painful or sensitive issues must be raised. Many teams hold family meetings in the NICU using an interdisciplinary approach, with attendance by physicians, nurses, and psychosocial professionals (social workers, chaplains, etc). A recent study sought to understand the contributions that different practitioners and family members make during these discussions.1

The study analyzed the communicative contributions of physicians, nurses, and other practitioners, as well as of family members, during simulated family meetings in the NICU. Video-recorded interactions were made as part of a series of education workshops on communication skills. Family members were portrayed by professional actors. During each session, communication focused on conveying bad news, introducing withdrawal of life support, or discussing withdrawal of life support.

Analysis revealed that practitioners verbally dominated the family meetings, talking substantially more than the family members. Mean practitioner utterances were 239 (70%) as compared with family member utterances of 101 (30%). Physicians spoke the most (56% of utterances), followed by nurses (33%). Practitioners devoted most of their statements to providing biomedical information. When compared with other practitioners, social workers and chaplains asked more psychosocial questions, sought more family opinion and understanding, and more frequently expressed agreement and approval.

The authors concluded that the unequal proportion of family-to-practitioner speech observed in this study highlights an area of clinical practice worthy of further exploration and improvement.

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