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In this issue:

Best Practice #4: Initiate Goals of Care Discussion - Part Three.

LAST MONTH:

We covered Question #1 of the six questions that will start to "map" the person’s values: 

Question 1:     “What are your most important goals if your health situation worsens?”

Assume you have asked this first question and responded to any emotion that the person may have had.

NEXT:
Exploring Goals, Values and Priorities: Question #2 (of 6)

Using the Serious Illness Conversation Guide:
Question 2:     "What fears, worries or concerns do you have about your illness?"
This question allows the patient to speak to the things that may be causing underlying distress. Many times, people put worries aside to focus on “positive” goals, or they may not want to burden their loved ones with their inner fears and worries. Having a chance to name these fears and concerns is often a relief and provides more insight into what is important to them (e.g., whether they are worried about symptoms, loss of function, or impact on family).
Over the coming months, we will cover the more questions that “map” the person’s values and goals. You will see how you can use these answers to know whether POLST is right for your patient.
Watch the 12-minute video of the entire conversation
Download the SICG script

Pro Tip: Respond to Emotion continued

Your genuine interest/presence with the person will create the safety they need to absorb information and be able to go on.

Responding to emotion can be done in many ways. Last month, we introduced N.U.R.S.E. statements to name these ways.
  • N - Name the emotion
    "This news is so upsetting."
  • U - use an Understanding statement
    "I can hear how difficult this must be."
Try to keep it neutral/objective (“...how difficult this must be” rather than “you are having a difficult time with this”).

Again, don’t worry about getting it wrong—they will correct you and name the right emotion. Stay humble and curious—your patient will so appreciate feeling heard and "gotten". 
 
Next month's issue:

The Goals of Care Conversation Part Three: Exploring Goals, Values and Priorities Question #3.
Click here to access the Washington POLST Clinician Toolkit
Visit the WSMA POLST page to view and order the POLST form and brochure, find translations, and access additional webinars around the Washington POLST.
Click here to access wsma.org/polst
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POLST and Your Practice is a service co-sponsored by the Washington POLST Task Force and the Honoring Choices Pacific Northwest.

You are receiving this newsletter as a clinician who cares for seriously ill people, or you have expressed interest in this topic. You may have attended one of our trainings or events. This newsletter is designed to: 
  • Improve the quality of conversations about goals of care and treatment preferences between seriously ill individuals and their care team.
  • Show how using a model for goals of care conversations, like the Ariadne Labs' Serious Illness Conversation Guide, can facilitate discussions that may lead to POLST completion.
  • Increase awareness among clinicians regarding when and for whom POLST should be offered.
  • Educate clinicians and care teams about the purpose and use of POLST forms, ensuring that POLST forms are filled out correctly and accurately reflect the individual’s treatment preferences.
  • Maximize appropriate use of POLST to ensure people receive care that honors personal values and preferences at the end of life.
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