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Exploring the Essential Features of “Nancy Joyner – Serious Illness Messaging and Crucial Conversations”
Speaker: Nancy E. Joyner, RN, MS, APRN-CNS, ACHPN®
Duration: 3 Hours
Format: Audio and Video
Copyright: Oct 20, 2023
Media Type: Digital Seminar
Description
One of the biggest challenges healthcare professionals face is the serious illness messaging and critical conversations that are vital for patient care. Advance care planning is often overlooked. Many patients we see simply do not have one. However, the important aspect of guiding patients through their medical treatment and care involves very specific discussions for them. In this session, you will learn about advance care planning and your role in it. You will also learn about serious illness messaging, conversation steps and guidelines, the power of four words, and how to address consent and decision-making challenges. We will end with a discussion on addressing the most difficult questions “how long do I have?”
Speaker
Nancy Joyner, RN, MS, APRN-CNS, ACHPN® is a nationally recognized consultant, speaker, educator and author. As a Palliative Care Clinical Nurse Specialist, she works as the palliative care specialist disseminating awareness and education regarding palliative care statewide. Nancy has over 40 years of nursing proficiency that includes 17 years as an advanced practice nurse in palliative care. Nancy is an End-of-Life Nursing Education Consortium (ELNEC) trainer. She has had training through the Center to Advance Palliative Care (CAPC). Nancy created numerous CME sessions on palliative care for the University of North Dakota’s Project ECHO and is involved with the Dakota Geriatric Workforce Enhancement Program. She has presented and published at local, state, and national levels. She has researched and published articles on POLST and advance care planning. Nancy is an ambassador for the Serious Illness Community of Practice, Ariadne Labs. She is currently president of Honoring Choices® North Dakota, North Dakota’s POLST Program Coordinator and co-creator of the HCND ACP Facilitator Certification Course.
Speaker Disclosures:
Financial: Nancy Joyner maintains a private practice and has employment relationships with Center for Advancing Serious Illness Communication/MMA/MHA, Honoring Choices® North Dakota/Quality Health Associates of North Dakota, and Center to Advance Palliative Care Designation. She receives royalties as a published author. Nancy Joyner receives a speaking honorarium and recording royalties from PESI, Inc. She has no relevant financial relationships with ineligible organizations.
Non-financial: Nancy Joyner is a member of Minnesota Network of Hospice and Palliative Care, the National Association of Clinical Nurse Specialists, and others.
Objectives
- Determine three measures to bring awareness of Advance Care Planning (ACP) to your facility.Â
- Analyze two action steps to implementing ACP conversations.Â
- Evaluate serious illness messaging and how to incorporate it into your practice/agency. Â
- Recognize tools, tests and instruments used in assessing and discussing prognosis.Â
- Plan your own conversations regarding choices, values, and wishes.Â
Outline
What is Advance Care Planning (ACP)
- Why is ACP important and needed?Â
- Benefits and barriersÂ
- Continuum of ACPÂ
- Impact of unwanted, nonbeneficial treatmentÂ
- Why ACP discussions are not startedÂ
What is Serious illness
- Serious illness/Dying trajectoriesÂ
Serious Illness Messaging
- Serious illness conversation guideÂ
- COVID-19 response toolÂ
- Vital talksÂ
- 2023 serious illness conversation guideÂ
Communication and Critical Conversations
- Communication needs of the patientÂ
- Communication needs of the familyÂ
- Patient and family expectationsÂ
- Communication and shared decision makingÂ
- Who initiates the discussionÂ
- Tools to assist ACP conversationsÂ
- Explain the default policyÂ
- Non-beneficial treatmentÂ
- Questions for the doctorÂ
- Questions at the time of diagnosisÂ
- How much can we shareÂ
The Power of Four Words
- “What Matters to You”Â
- What to discussÂ
- Culturally appropriate discussionsÂ
- Goals of care/ Treatment options discussionÂ
- Centering treatment on what mattersÂ
- Lack of continuityÂ
Treatments to Prolong life
- Video, “Ain’t No Way to Die”Â
- CPR discussionÂ
- Responding to emotionÂ
- COVID 19 and critical conversationsÂ
- Maintaining hope and truth Â
Addressing Consent and Decision-Making Challenges
- Medical/professional obligationsÂ
Advance Care Planning Documents
- What is an advance directive (vs a will)?Â
- When to review an advance directiveÂ
- Misconceptions about advance directivesÂ
- When to do an advance directiveÂ
- What is a healthcare agentÂ
- Things to consider when choosing a healthcare agentÂ
- Examples of a healthcare agentÂ
- What is POLSTÂ
- Where does POLST fit in?Â
- Comparing advance directive to POLSTÂ
- Our role with POLSTÂ
- What happens in an emergency situation?Â
“How long do I have?”
- What is medical prognosisÂ
- Determining prognosisÂ
- What about the probable outcomeÂ
- Scales and tools to assist with prognosticationÂ
- Our role is prognosis communicationÂ
- Using the Serious Illness Conversation GuideÂ
- Cultural considerations about disclosure of diagnosis and prognosisÂ
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