Serious Illness Messaging and Crucial Conversations

Credit

Handouts/Brochure

Speaker

Nancy E. Joyner, RN, MS, APRN-CNS, ACHPN® Related seminars and products

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Nancy Joyner, RN, MS, APRN-CNS, ACHPN® is a nationally recognized consultant, speaker, educator and author. As a Palliative Care Clinical Nurse Specialist, she works as the palliative care specialist disseminating awareness and education regarding palliative care statewide. Nancy has over 40 years of nursing proficiency that includes 17 years as an advanced practice nurse in palliative care. Nancy is an End-of-Life Nursing Education Consortium (ELNEC) trainer. She has had training through the Center to Advance Palliative Care (CAPC). Nancy created numerous CME sessions on palliative care for the University of North Dakota’s Project ECHO and is involved with the Dakota Geriatric Workforce Enhancement Program. She has presented and published at local, state, and national levels. She has researched and published articles on POLST and advance care planning. Nancy is an ambassador for the Serious Illness Community of Practice, Ariadne Labs. She is currently president of Honoring Choices® North Dakota, North Dakota’s POLST Program Coordinator and co-creator of the HCND ACP Facilitator Certification Course.

 

Speaker Disclosures:
Financial: Nancy Joyner maintains a private practice and has employment relationships with Center for Advancing Serious Illness Communication/MMA/MHA, Honoring Choices® North Dakota/Quality Health Associates of North Dakota, and Center to Advance Palliative Care Designation. She receives royalties as a published author. Nancy Joyner receives a speaking honorarium and recording royalties from PESI, Inc. She has no relevant financial relationships with ineligible organizations.
Non-financial: Nancy Joyner is a member of Minnesota Network of Hospice and Palliative Care, the National Association of Clinical Nurse Specialists, and others. For a complete list, please contact info@pesi.com.

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Objectives

1. Determine three measures to bring awareness of Advance Care Planning (ACP) to your facility. 
2. Analyze two action steps to implementing ACP conversations. 
3. Evaluate serious illness messaging and how to incorporate it into your practice/agency.  
4. Recognize tools, tests and instruments used in assessing and discussing prognosis. 
5. Plan your own conversations regarding choices, values, and wishes. 

Outline

What is Advance Care Planning (ACP) 

• Why is ACP important and needed? 
• Benefits and barriers 
• Continuum of ACP 
• Impact of unwanted, nonbeneficial treatment 
• Why ACP discussions are not started 

What is Serious illness 

• Serious illness/Dying trajectories 

Serious Illness Messaging 

• Serious illness conversation guide 
• COVID-19 response tool 
• Vital talks 
• 2023 serious illness conversation guide 

Communication and Critical Conversations 

• Communication needs of the patient 
• Communication needs of the family 
• Patient and family expectations 
• Communication and shared decision making 
• Who initiates the discussion 
• Tools to assist ACP conversations 
• Explain the default policy 
• Non-beneficial treatment 
• Questions for the doctor 
• Questions at the time of diagnosis 
• How much can we share 

The Power of Four Words 

• “What Matters to You” 
• What to discuss 
• Culturally appropriate discussions 
• Goals of care/ Treatment options discussion 
• Centering treatment on what matters 
• Lack of continuity 

Treatments to Prolong life 

• Video, “Ain’t No Way to Die” 
• CPR discussion 
• Responding to emotion 
• COVID 19 and critical conversations 
• Maintaining hope and truth  

Addressing Consent and Decision-Making Challenges 

• Medical/professional obligations 

Advance Care Planning Documents 

• What is an advance directive (vs a will)? 
• When to review an advance directive 
• Misconceptions about advance directives 
• When to do an advance directive 
• What is a healthcare agent 
• Things to consider when choosing a healthcare agent 
• Examples of a healthcare agent 
• What is POLST 
• Where does POLST fit in? 
• Comparing advance directive to POLST 
• Our role with POLST 
• What happens in an emergency situation? 

“How long do I have?” 

• What is medical prognosis 
• Determining prognosis 
• What about the probable outcome 
• Scales and tools to assist with prognostication 
• Our role is prognosis communication 
• Using the Serious Illness Conversation Guide 
• Cultural considerations about disclosure of diagnosis and prognosis