Clinical Challenges in Surgical Palliative Care: Communication Skills for Difficult Conversations

Behind The Knife: The Surgery Podcast

Medicine, Health & Fitness, Education, Science

4.8 • 1.4K Ratings

🗓️ 6 May 2024

⏱️ 37 minutes

🔗️ Recording | iTunes | RSS

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Summary

Your patient was in a terrible car crash and is currently intubated with multiple traumatic injuries that will need surgery. Family has just arrived and all they’ve heard is that he has a broken leg. How do you share this serious news with family? What do you do when they become angry, cry or bombard you with questions that you don’t have answers to? Join the surgical palliative care team from the University of Washington as we role play a difficult conversation with a standardized patient. We will identify common challenges that arise and discuss key skills to navigate these situations.

Hosts:

Dr. Katie O’Connell (@katmo15) is an assistant professor of surgery at the University of Washington. She is a trauma surgeon, palliative care physician, director of surgical palliative care, and founder of the Advance Care Planning for Surgery clinic at Harborview Medical Center, Seattle, WA.

Dr. Ali Haruta is a PGY7 current palliative care fellow at the University of Washington, formerly a UW general surgery resident and Parkland trauma/critical care fellow.

Dr. Lindsay Dickerson (@lindsdickerson1) is a PGY5 general surgery resident and current surgical oncology research fellow at the University of Washington.

Dr. Virginia Wang is a PGY2 general surgery resident at the University of Washington.

Learning Objectives:

· Identify common pitfalls encountered during difficult conversations
· Learn how to synthesize complex medical information and construct a succinct headline statement to deliver a digestible take-home message
· Develop skills to respond to emotional cues using empathetic statements

References:

· “Responding to Emotion.” Vitaltalk. Accessed March 4, 2024. https://www.vitaltalk.org/guides/responding-to-emotion-respecting/
· “Serious News.” Vitaltalk. Accessed March 4, 2024. https://www.vitaltalk.org/guides/serious-news/

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Transcript

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0:00.0	Behind the surgery podcast relevant and engaging content designed to help you dominate the day.
0:13.0	To
0:15.0	To
0:18.0	everyone, Welcome back to another episode of
0:24.4	behind the knife the palliative care team from the University of
0:27.3	Washington I'm Ali joined by Dr. O'Connell Lindsay and Virginia today any of the special. Today we'll be talking about some specific skills
0:36.4	for serious illness communication.
0:39.0	We'll be demonstrating these skills
0:40.6	through a simulated scenario and identify some common sticking or challenge
0:44.6	points we encounter. Then talk about tips for how to navigate them. To help us today we have
0:49.8	two guests who will be playing out a doctor patient scenario. We have surgery resident
0:54.4	Dr. Grace Pac playing our surgeon and an SP playing Brenda Lewis the mother of
0:58.8	an ICU patient. Now as we go through the role play we will be periodically timing out
1:05.0	pausing the scenario so we can talk about what's going on, game plan next steps, and
1:10.2	then replay the scenario utilizing these new skills.
1:13.4	Grace, if you're feeling stuck at any point, feel free to time yourself out to you.
1:18.2	Okay, let's start. Virginia, why don't you read the case to our listeners?
1:22.3	Sure, this case is about patient Robert Lewis,
1:25.0	and you'll be speaking with his mother, Brenda.
1:27.0	Robert is a 23-year-old man who was rock climbing
1:30.0	when he fell about 50 feet and sustained a TBI and a C5 fracture with associated cord injury and resulting
1:35.9	quadriplegia. He was taken urgently to the OR for spine stabilization but since has not been seen to move his arms or legs.
	...

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