Communicating With Families: Shifting the Focus

This pandemic has thrown us one curveball after another; for example, it has upended how we communicate with families. Families can’t visit patients, can’t be at the bedside, can’t see how diligently the medical and nursing teams are caring for the patient, can’t be there when a loved one dies. As a result, there is a huge focus in the media and among the public on what we can’t do.

Nurses have the passion, perseverance and grit to change this focus. While we’ve had to adapt our methods of communicating with families, our drive to innovate and deliver holistic care is intact. So let’s refocus from what we can’t do to what actions we can do.

Especially now, our own emotions mixed with patients’ and families’ anxieties and fears contribute to how we communicate as clinicians and how patients and families synthesize the information we give them. To overcome this, experts in the field of communication can help us integrate new information delivery techniques.

VITALtalk.org and the Center to Advance Palliative Care (CAPC) offer phenomenal resources to help adapt our communication strategies in the climate of COVID-19. The rapport and trust we normally build in-person with patients and families during our shifts are now absent, so the nuances of our conversations via phone or video chats become vital. Some suggestions and reminders include:

• Take a moment to prepare for the interaction. Create your own microenvironment of calm, safety and caring. This emotional energy will come through via phone or video chat.
• Be descriptive, painting a picture of what’s happening in the room so that the family can visualize.
• Acknowledge the emotions that you are hearing, even anger.
• Demonstrate respect by listening fully before providing answers.
• Ask proactive questions such as “When were you updated last, who did you speak with and what information did they give you?” and “How are you doing given that information?” The answers can give you context about how the family member is coping and where they are emotionally, helping you tailor your information delivery to their needs.
• Anticipate questions and answers. The Communication Playbook from VITALtalk.org has talking maps that can aid in different situational conversations, including allocation-of-resource decisions and final goodbyes.

In addition to general tips about video and phone communication, CAPC provides scripts and short videos of communication specific to the pandemic.

These communication techniques do require time to coordinate, deliver and develop trust with families, time that may compete with our clinical care. This is where nurses can innovate and develop new strategies, collaborating with leadership, clinical nurses and key stakeholders to delegate and allocate communication.

Examples of such innovation might look like this. A colleague of mine described how leadership rounds on her unit have morphed into the nurse manager communicating with families via video calls. Another nurse manager colleague, whose nurses use a team nursing model, delegates one nurse to be the primary communicator to the family and to coordinate the logistics of updates.

Nurses historically have risen to challenges. When circumstances are out of our control and some focus on can’t, we show that we can. Yes, we CAN … just watch us.

What strategies is your unit using to adapt to the changes in communicating with families?