Make a Recommendation
Helpful Tips
When making a recommendation, be sure to carefully acknowledge what the patient and family have told you.
If you listen, but then you recommend something different than what they have requested, it can come across as “not listening” and the conversation may be counterproductive.
It is valuable to make a clear recommendation. Your recommendation may not be accepted immediately — because of lack of information or denial or miracle-based beliefs. But most people appreciate a physician who expresses an informed opinion in a caring way.
You may hear that a family wants “every possible day that medicine can give,” and that their mother would want to be intubated, etc. Acknowledge their goals and share your professional opinion:
“It sounds like you are hoping that by putting your mom on a ventilator, it will prolong her life. However . . . “
You can then say that there is a lot that can be done short of intubation to ensure she is well treated and as comfortable as possible. But remember that you did ask about their goals so your recommendation needs to give evidence that you listened!
Another approach could be to consult the ICU to see if a trial of ICU level care is something that can prolong her life. The ICU can say, no, that won’t actually prolong her life, in which case, you are in sync with families goals and providing them with good information.
Providing information in a sensitive realistic way allows the person to make an informed decision.
- Watch the video below for an example.
Discussion: Make a Recommendation
Participate in the discusssion by posting a comment below
You must be logged in to post a comment
k
respectful, lays out pros and cons, clear
clear presentation
Clear
VERY CLEAR PRESENTATION
very clear
Very clear and specific
md was good with the wife, was very specific
great discussion of goals of care
AA
need to maintain empathy with truth
Clear explanation about CPR outcome and provider’s opinion.
This is missing in real healthcare sometimes. Great answer he gives.
concise but meaningful explanation
Great explanation
Good explaination
Great
.
.
ep
Very clear
clear and concise
agree
ok
l
good family education
–
ok
Good approach
….
great
ok
ok
ok
.
clear good
it’s important that he asked her will he be ok with tha so she takes of her back a bit making hard decision
.
nice set goals
Good conversation.
Hard discussion to have but good for the family to understand the reality.
Inform the family so they understand.
Good to discuss goals
suggesting goals is good
recommendations are needed yet still need a joint approach
Great education allowing the caregiver to have input
clear, simple
well explained
clear,plain,simple and well received
great plan and discussion
ok
so true :better not to lead with- would he want cpr
clear plan initiated
Clearly outlined
the MD explained very well
the MD provided patient-centred care
Pros and cons, professional advice
MD is very respectful and tone of voice is calm when explaining
What if their wishes for their loved one prolong suffering? Is there an ethical way to talk them out of a position they’re adamant on?
Interesting choice of word “massage” to describe chest compressions in CPR?
Great educational videos, but they all load too slowly. Please, do something about that because it is annoying.
great
good info
Did a great job of guiding to the correct decision
good information
That was a very compassionate way to explain CPR and its likelihood of success. Well done
clear discussion
improve communication
good information
honest and complete information
Good to get families thinking about these things before admission
Good to get families thinking about these things before admission
clear advice
it is SO important to provide a recommendation rather than to just say “would he want CPR?”
We don’t ask patients “what kind of imaging test would you like today?” but we ask them questions that help guide us to forming a plan and recommendation; I think it is similar in goals of care discussions – we need to know what matters to the person and incorporate that in our giving of advice and making a medical plan.
Honest discussion about the probable outcome of CPR
teaching and clear information
clear advice
compassionate and i believe she understands what he is saying
Always important to outline plans of care
Honesty is key
Good job clarifying misunderstandings of interventions. Helping clients understand reality of ICU/ interventions,
good information
presenting the options that are in sync with what the patient/family wants
Clear and easy to understand physical comments
Gives a suggestion and permits wife to make the DNR call
I think the physican presented this very well and consistent with what the family member told him about her husband’s goals of care
Honest is the key
Leaves no room for false hope and allows family and patient to grieve in a healthy way.
very honest
clear advice
Clear advise is what is given. In toime the needs are of the wife to be able to live with a sound based decission.
hay que explicar en forma lenta pa verificar que el familiar o cuidador comprenda
exc management
hay que ayudar a la toma de desiciones
Clear advice!
yhbv
uyytrr
🙂
I thought the physician did well in explaining before hand, and that concluding it with a recommendation against CPR.
Clear advice on DNR status.
recommendations
x
yt
The doc listened attentively and answered questions appropriately and effectively.
he explained why it is unlikely to be successful and then made recommendations, did so in a respectful and empathetic manner
I really like that he addressed the unrealistic television portrayal of CPR and it’s success.
would you and your husband be ok with that?
The MD explained clearly what the outcome of ICU care or CPR would be. He was kind and supported the wife in helping her make end of life decisions for her husband.
at end of life discussion I like to include a little of the gory details of a code blue and this is definite not what the wife would want or the husband intubation and IV’s again.
the MD listened and outlined what the care plans would be
the MD explained clearly what each resuscitative procedure would have been and why either won’t work and thus not recommended