COVID‐19 and difficult conversations in critical units: A practical guide for nurses

• Published in: Nursing in Critical Care 2021-05, Vol.26 (3), p.209-211
• Main Authors: Felix, Adriana M. S., Pereira, Erica Gomes, Cambuí, Yasmin, Souza, Regina Claudia
• Format: Article
• Language: English
• Subjects: Communication; COVID-19; Critical care; Empathy; Families & family life; Nursing; Nursing care; Palliative care; Severe acute respiratory syndrome coronavirus 2
• ISSN: 1362-1017; 1478-5153
• DOI: 10.1111/nicc.12584

Working in a health emergency of such magnitude tends to generate physical and psychological stress that cannot be underestimated.2 Nursing critical care patients of any age group can cause emotional tension and physical exhaustion, and this experience is accentuated when caring for patients infected with COVID‐19 at the end of their lives.3 In this context, fear, incapacity, and anxiety regarding breaking bad news can be high because many professionals (especially those who have been relocated to critical units because of the pandemic) are working outside their original units and may possess limited experience to serve families of patients at the end of their lives.2, 4, 5 The term “communicating bad news” or “communicating difficult news” is a communication process that occurs before, during, and after the communication of some bad news and is considered health information that alters a person's perception of the present and future in a negative way.6 Usually, it is the medical team who disclose difficult news to patients and their families. [...]families may have a preference for conversations with nurses because of their proximity in the nurse‐family‐patient relationship and the fragility of the relationship with other professionals from the team.7-9 The task of communicating bad news is a complex skill that requires empathy, appropriate body language, and a welcoming voice tone, among other measures that are impaired in the context of the COVID‐19 pandemic.10 Physical distancing prevents touching or hugging, impedes face‐to‐face conversations regarding the side effects or symptom evolution, and often makes family farewells unfeasible when the patient dies. Mental health care for medical staff in China during the COVID‐19 outbreak. Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019.