Patient Communication Skills Flashcards

A mechanically ventilated patient with a tracheostomy is attempting to communicate distress. Which augmentative and alternative communication (AAC) strategy should be trialed first?

Answer: Offer a simple yes/no head-nod system before progressing to letter boards

A hierarchical AAC approach starting with simple yes/no signals minimizes patient frustration and is the recommended first step in ICU communication.

When disclosing a poor prognosis to a patient's family in the ICU, which communication framework is most evidence-based?

Answer: SPIKES (Setting, Perception, Invitation, Knowledge, Emotions, Summary)

The SPIKES protocol is specifically designed for delivering bad news and is widely validated in critical care settings.

A patient who is alert but intubated becomes increasingly agitated. After ruling out medical causes, the most appropriate initial communication intervention is:

Answer: Establish a reliable yes/no signaling method and assess for pain and anxiety

Establishing a reliable communication channel addresses the root cause of agitation in alert intubated patients before escalating sedation.

During a family meeting about withdrawing life-sustaining treatment, a family member says 'He would have wanted everything done.' The best clinician response uses which technique?

Answer: Reflect the emotion and explore what 'everything' means to the family

Reflective listening and clarifying the meaning of 'everything' helps uncover the patient's values and facilitates shared decision-making.

Which element of the NURSE mnemonic is being used when a clinician says, 'I can only imagine how frightening this uncertainty must be for you'?

Answer: Empathizing

The statement directly acknowledges and validates the family member's emotional experience, which is the core of the Empathizing element.

An ICU patient from a non-English-speaking background requires an interpreter for a goals-of-care discussion. The patient's bilingual adult child offers to interpret. The best approach is:

Answer: Use a professional medical interpreter to ensure accuracy and avoid burdening the child

Professional interpreters reduce errors, avoid placing emotional burden on family members, and maintain confidentiality and neutrality in complex discussions.

After a prolonged ICU stay ending in patient death, which communication action best supports the bereaved family?

Answer: Offer a bereavement follow-up meeting or call within 30–90 days to answer questions and provide support

Proactive bereavement follow-up reduces complicated grief and PTSD symptoms in ICU family members, and is recommended by international guidelines.