Family Updates in the ICU

##First conversation:

• introduce yourself and the team members.
• clarify when you will be available, or what other team members are available and for how long
• start by asking what they've been told with a flag that you're interested so you can start at the right place, not as a 'quiz' (phrasing it like this can help to avoid the dynamic where they feel like their healthcare literacy is under question and something to be embarrassed about)
• when you give updates, reference specific tests/results

##Are they going to be ok? Almost no one is ever, with certainty, going to be fine who is in the ICU. Your goal should be to have them understand what is wrong with the patient and reassure them that their family will be well cared for. However,

##Code status:

• "What do you think the patient would have wanted" as a frame. Off loads feeling of responsibility
• learning about the patients and values and preferences - what did they really like to do?
• offer a recommendation, with a signal that you're curious if they agree.
• would they want input from someone else?

Code status when things are going badley

• NEVER just straight up ask "do you want us to do chest compressions and put a tube down your throat?"
• NEJM article framework.

Documentation:

• if decisions- identify if patient can participate, or if not, why not
• document what the purpose of the discussion was
• document information shared, concerns, and