Colleagues

Discussing treatment (particularly treatment limitation) with colleagues outside of the unit can be challenging. Some important considerations are:

Standard communication tips apply:

• Warning shots
• Giving time to process what is being said
• Respond to emotions

• Acknowledge uncertainty
• Be humble
  You can be wrong.
• Be prepared to negotiate
  Consider:
  • Time-limited trials
  • Second opinion
  • Waiting a day
• Maintain professionalism
  The working relationship will continue after the therapeutic relationship with this patient has ended.
• Develop good relationships with colleagues outside of the ICU
• Recognise the efforts and successes of your colleagues
• Focus on your area of expertise, not theirs
• Flag deterioration early
• Discuss patients in private, away from the bedside
• Come to a consensus before announcing a plan to the family
• Focus on what you are doing, not on what you want to withhold or stop

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1. CICM Communications Course. Course Notes. 2023.