The them today was goals of care. I’ve talked about this a bit before on my internal medicine rotations and the Palliative Care attending that I had and the tips that he shared. Compared to IM though, these conversations are happening on a weekly if not daily basis in the ICU. It definitely makes me think a lot about how I would approach having these conversations with patients and families.
My attending this week offered an approach that I thought was pretty compelling. It was a pretty simple one in that in many of these cases we have done everything we can to help patients recover, and so her approach was to let patients know that, which I know seems basic and common, but she also stress the importance of explaining what improvement looks like to us from a medical perspective and what deterioration looks which I think is helpful in setting expectations with patients and their families. Being objective in these conversations does necessary have to mean being cold, and the objective aspects of a patients health or lack there of can be delivered with compassion and ultimately should help guide patients and their families to being at peace with whatever decisions they decide to make.
nANIMOv 