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  • Introduction
  • 1. Advance Care Planning
  • 2. Communicating Bad News
  • 3. Whole Patient Assessment
  • 4. Pain Management
  • 5. Assisted Suicide Debate
  • 6. Anxiety, Delirium
  • 7. Goals of Care
  • 8. Sudden Illness
  • 9. Medical Futility
  • 10. Common Symptoms
  • 11. Withholding Treatment
  • 12. Last Hours of Living
  • 13. Cultural Issues
  • 14. Religion, Spirituality
  • 15. Legal Issues
  • 16. Social and Psychological
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    Site Index
    Back to Module 8: Sudden Illness
    Seven Guiding Principles

    Principle 1. Provide Structured Interaction Principle 2. Communicate the Range of Possible Outcomes

    Principle 1. Provide Structured Interaction

    Communicating in the Chaos of Sudden Illness Situations

    • Provide structured interactions in the otherwise chaotic environment by establishing regularly scheduled communications between specific identified parties from both the family and the health care team
    • Much of the information covered in this module deals with ways to bring structure to a situation of stress and uncertainty. Often this is a confusing time, for many reasons:
      • The family is trying to cope with the shock of the situation

      • Things may be happening very quickly

      • There may be a need to involve multiple members of the family at a moment’s notice

      • Most importantly, there will probably be multiple physicians and other members of the health care team providing different aspects of care to the patient
    • In this atmosphere, coordinating information about the patient's condition and potential decisions can become a challenge
    • A structured communication process can:
      • Help reduce confusion
      • Facilitate effective decision-making


    Identifying Spokespersons

    • Encourage one person on both sides (physician/team and patient/family) to act as the primary spokesperson and communicator
    • The goal is not to cut off communication between the family and other physicians, but rather to minimize confusion
    • Depending on the situation, the primary doctor who serves as spokesperson could be:
      • The primary care physician
      • The intensive care unit physician
      • Another physician
    • The spokesperson for the family does not necessarily have to be the decision-maker


    Coordinating Communication and Decision-Making Efforts

    • Try to coordinate all information and decisions through the spokesperson
    • Try to meet with the patient/family spokesperson and decision-maker at the same time, if both exist
    • Restricting the number of meetings may be challenging when there are many family members visiting at various times throughout the day who all want information. The following suggestions may be helpful:
      • Ensure that everyone on the health care team understands the communication process that has been established

      • Tell all the family members and the members of the health care team about the communication plan

      • Identify regular times when you will communicate with everyone who wishes to be present


    Incorporating Basic Communication Skills

    • Using good communication skills can be more important than ever in situations of sudden illness, where emotions are likely to be prominent and fragile
    • Follow these steps of good communication when conveying any information:
      • Get the setting right for the information
      • Find out what family members know before sharing new information
      • Respond to their feelings
      • Finish with a concrete plan
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