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In this issue:

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


We covered Question #1 and Question #2 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?”
Question 2:     “What fears, worries or concerns do you have about your illness?”

As always, while asking these questions, you will want to respond to any emotion cues that the person may give you that they need time to process before moving on.

Exploring Goals, Values and Priorities: Question #3 (of 6)

Using the Serious Illness Conversation Guide:
Question 3:     "What gives you strength as you think about the future with  your illness?"
This question allows the patient to speak to the things that may be sources of hope, encouragement, and inspiration.  This helps balance the emotional weight of the earlier question about fears and worries.  This question is most effective precisely at this point in the conversation, as the SICG indicates
Watch the 12-minute video of the entire conversation
Download the SICG script

Pro Tip: Respond to Emotion continued

Responding to emotion can be done in many ways. 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."
  • R - use a Respect statement
    “I see how hard you have worked to try to get through this illness.”
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:

As promised, we will cover more of the questions that “map” the person’s values and goals over the next 3 months. You will see how you can use these answers to know whether POLST is right for your patient.

Best Practice #4 Continued: The Goals of Care Conversation Part Three - Exploring Goals, Values and Priorities, Question #4: Exploring Critical Abilities.
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.
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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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