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communication, discussions, end-of-life, goals of care, life-limiting disease



  1. Peereboom, Karen BSN, RN
  2. Coyle, Nessa PhD, ACHPN, FAAN


Communication is central to nursing care-especially in the setting of a progressive disease, which will end in the patient's death. This article outlines a variety of communication strategies designed to enhance nurses' communication skills and to provide them with tools to use as they discuss goals of care and treatment options with patients throughout their disease trajectory. These strategies are tools that can be especially helpful when treatment focus shifts from cure to comfort and quality of remaining life. The function of communication is to reduce uncertainty and to provide a basis for action. Clumsy communication can cause harm, "paralyze" action, and destroy the patient-nurse relationship. The described strategies are designed to decrease the likelihood of such outcomes. A case study illustrates the use of these strategies throughout a patient's disease trajectory.