In the Preface of the book, Rotte and Lopez give a list of important themes to keep in mind as a starting point in any difficult situation or with difficult people.
Acknowledge and deal with conflicts as they arise. As difficult as this can be, it can prevent future issues and the compounding of problems.
At every patient encounter, try to explicitly identify patient expectations, and give realistic goals for care. For example, patients need to know if a certain medication is curative, preventative, or used to relieve symptoms.
Introduce yourself to every person present. This is a common courtesy and will help identify individual relationships.
Identify yourself and your role in the patients care. There are many professionals playing a variety of roles in healthcare. It is important patients and loved ones know your role.
Avoid using medical terminology with patients. It is vital patients understand their conditions, tests and procedures, and medications. As a medical professional, it may become second nature to speak in complex medical terms, but the average patient will need to understand difficult concepts by hearing simple phrases and explanations.
Don’t palm off responsibility to other providers. Deflecting blame onto another facility or healthcare provider will damage patient confidence and is not professional behavior.
Always keep your cool. If you loose your head and express yourself in a negative way, your standing among coworkers and your patients will diminish and make it more difficult to solve the conflict at hand.
The next seven chapters in the book give specific situations and possible responses. I found several helpful hints throughout the book, but the chapter on breaking bad news was particularly informative and helpful. Even though as a nurse, I may not be doing this on a regular basis, I’m sure I will be involved in a fair share of these situations. The book gave many examples of how to express empathy such as “This must be just terrible news for you.” and “I wish things were different.”
It also talked about a growing trend in medicine to let family members be present during resuscitation attempts and how to handle that situation. In the emergency department, having family members present during resuscitations is well recognized and documented among policy makers.(Porter, 2012). In my current career as a veterinary technician, this is always a challenging situation. Pet owners want to be with their animals, but I never know if that is the right choice. They may see our efforts as cruel or callous. In the book it is suggested that family members be warned of these potentials and accompanied by a nurse to explain what they are seeing.
Another particularly helpful tip is to be straight forward and use concrete words like dead and died. The text suggested that using euphemisms such as “passed on” or “moved on” may be misinterpreted or considered insensitive. Phrases such as “it was his time” or “in a better place” may seem disingenuous or judgmental. I have used these phrases myself many times and never thought of it this way, but it makes sense. I will have to be much more conscience of my phrasing in the future. An alternative example given