Patient Communication Skills Flashcards

A family insists on cardiopulmonary resuscitation for a patient the entire multidisciplinary team believes will not survive cardiac arrest. The ethically appropriate next step is:

Answer: Arrange a structured family meeting with palliative care to explore values and reach shared understanding

A structured family meeting with multidisciplinary support is the recommended first step to address conflict over CPR, prioritising communication before formal dispute resolution.

Which validated tool is specifically designed to assess ICU family members' satisfaction with communication and decision-making?

Answer: FS-ICU (Family Satisfaction in the ICU)

The FS-ICU is a validated 34-item questionnaire measuring family satisfaction with care and decision-making in the ICU.

A patient with a known advance directive refusing intubation is admitted unconscious following a drug overdose. The most appropriate action is:

Answer: Review the advance directive's scope, consult the next of kin, and apply clinical judgment about reversibility before proceeding

Advance directives require contextual interpretation; their applicability to a potentially reversible overdose must be carefully assessed with family and clinical judgment.

When conducting an ICU family meeting, which seating arrangement and environmental factor is most conducive to effective communication?

Answer: All participants seated at eye level in a private room away from the bedside

Seated, eye-level communication in a private space reduces power differentials, limits distractions, and signals that adequate time is being given to the family.

A patient with locked-in syndrome following basilar artery stroke retains full cognitive function. The most appropriate communication adaptation is:

Answer: Establish an eye-movement or blink-based code system for yes/no communication

Locked-in syndrome preserves cognition while abolishing voluntary movement except for vertical eye movements and blinking, which form the basis of reliable communication.

During handover communication in the ICU, which practice most reduces information loss about a patient's goals of care?

Answer: Documenting goals-of-care discussions in a dedicated, standardized section of the medical record

Standardized documentation of goals-of-care in a dedicated record location ensures continuity and reduces the risk of clinicians acting against documented patient wishes.

A patient recovering from critical illness describes intrusive memories of ICU procedures. According to post-ICU syndrome (PICS) evidence, the most beneficial intervention is:

Answer: Offer a structured ICU diary review with psychological support to help contextualise the experience

ICU diaries have evidence supporting their role in reducing PTSD and helping patients reconstruct the narrative of their critical illness, reducing the impact of traumatic memories.