10 February 2023

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The secret to sensitive conversations is…

St Christopher’s Visiting Lecturer and Clinical Nurse Specialist shares her insights on mastering communication with patients and their families and explains why our Sensitive Conversations course is a must for all.

Maria Aparicio

Every health and social care professional working in palliative care knows that communication matters. But how many feel truly confident and comfortable knowing what to say to whom and when? St Christopher’s Visiting Lecturer Maria Aparicio can’t stress enough how important it is to get communication right and in this interview spells why our Sensitive Conversations course is a must for anyone wanting to provide quality care at the end of life.

Why is it important to master the art of sensitive conversations?

It is super-important because everything we do as health professionals starts with communication and the people we care for will remember it for both good and bad reasons. Everyone knows how to speak but not always how to communicate in the appropriate way and the right time.

Our goal is to relieve suffering but If I don’t know how to approach a sensitive topic in a sensitive way then I can end up causing more harm and stress.

As important as the knowing the right things to say is being able to listen – with your ears of course, but also with your eyes. I recently read that we listen to reply not to understand. It’s that understanding though that is so important.

How does this work in practice?

If I want to know about a patient’s symptoms I have to listen to what they have to say and of course ask the right questions, at the right time and be aware when I do not need to say anything, but just being there. If I want to support a patient’s family I need to know when to talk and when to listen so they feel comfortable telling me what they need. Our presence and body language can communicate a great deal too.

Can you think of an example from your practice as a nurse where you managed a sensitive conversation?

I had a patient who was very ill and in pain and struggling to manage her own personal hygiene. I gave her medication for her pain and she asked me, ‘how is it going to be now’. I thought for a moment that she was asking about her personal care because it was that time in the morning, but I thought twice, and then asked her what she meant. She said, ‘how am I going to die.’ I could have just interpreted her question as a question about that moment, but from experience, training and instinct,  I was able to sense that she was asking something deeper.

And that’s what often happens, spontaneously, unexpectedly, so you can’t always plan for it. The more experience you have, the better you get and that is why to  practice in a safe environment is really important.

Tell me about your own personal experience of learning to communicate sensitively about death and dying?

I think there is something in my personality but I also I read a lot about communication and I  had a very good teacher – a doctor in Portugal. Being with her was like watching a masterclass, she was sensible, followed the tools of breaking bad news and no matter how many times she had those conversations with patients and their families, she always made them feel like it was the first time – because it was for them and every patient is unique. She always sounded genuine and that is so important.

Tell us what people should expect from the Sensitive Conversations course?

The most important thing to know is that you won’t just be sitting in front of a PowerPoint presentation for two days. It’s a very engaging and interactive course with plenty of experiential learning. There is some formal teaching but there’s also a chance to observe and comment as well as practice communication skills in different scenarios.

Who should come on the course?

I would say anyone involved in palliative care should come, nurses, allied health and social care professionals and doctors. The last time we ran the course we had some very senior nurses and they found they learned so much.

What would you hope people will take back to work from the course?

I think they’ll return to work feeling more confident to approach sensitive conversations, and have the tools so they don’t feel like they have to run away from difficult conversations for fear of causing more harm than good.

If you had one tip for improving sensitive conversations, what would it be?

Listen to the patient and their families. Most people are worried about what to say when in fact you should be thinking more about listening, actively listening.

To see upcoming courses, check out our Education Calendar here.

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