Difficult conversations

Difficult conversations: a selection of related articles across categories. Start with the issue closest to your situation; articles are ordered by relevance to the topic.

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    Difficult diagnoses in practice: delivering bad news as a step-by-step processHow to deliver difficult diagnoses under time pressure: set the scene, pace information, use NURSE, realistic hope, three steps, a backup plan, and follow-up.SPIKES for difficult patient conversations: a map, not a performanceUse SPIKES as a map, not a script: micro-scripts, anchors, telehealth cues, fact–feelings–plan closure, and a quick post-visit debrief.Fear or plain arrogance? How to read a difficult patient’s intent and pick the right approach in the clinicHow to quickly spot fear, shame and control needs vs aggression. Clear cues, useful phrases, boundaries, de-escalation and documentation for clinicians.USA: Maya Kowalski — when hospital and family collide in care. How to talk without harmMaya Kowalski case lessons: de-escalate hospital–family clashes, align pain care with safeguarding, and lead clearer family meetings.Leading Difficult Conversations in Teams: Strategies and TechniquesLead tough team talks with a clear goal: prep with facts, use a simple framework, listen actively, and follow up.The delicate art of saying no in medicine: how to decline antibiotics or referrals without sparking conflictClear language, criteria, and backup plans to refuse antibiotics or referrals without escalation. Includes scripts, compromises, and visit wrap-up steps.Conspiracy of silence: how to proceed when family withholds a diagnosis from the patientPractical guidance on honoring patient autonomy, talking with family, using ask–tell–ask, documenting consent, and engaging the team in high‑risk situations.Tough talks about treatment costs: how to discuss money without shame and make the plan realisticHow to discuss costs without stigma, map barriers, and close an A/B/C plan. 2×2 scripts, non-medical costs, checklists, and calm ways to respond to anger.Medicine and hope: how to sustain long‑term communication with an oncology patientKeep oncology talks honest and hopeful: calibrate prognosis, set an agenda, discuss side effects and boundaries, and close with a clear plan.ER minefield: fast crowd communication, triage updates, and conflict de‑escalationPractical ER scripts: 30‑sec first message, micro‑apologies, predictable updates, one‑line triage, shame‑free de‑escalation.The sweet spot in patient care: clinical empathy without slipping into a therapist’s rolePractical guides for patient talks: concise empathy lines, a mini visit agenda, soft redirects for tough topics, and clear safety steps when a crisis arises.Chronic pain: patient support and clear visit structureClinician guide to chronic pain visits: validate without overpromising, set functional goals, define boundaries, add a safety plan.Empathy with boundaries in the clinic: how to be warm without giving up control of the visitUse empathy in clinic visits without losing control: scripts to set structure, say no with options, de-escalate, close plans, and document.Go-to lines for healthcare teams: short phrases to defuse conflict and get cooperation back on trackPractical scripts for healthcare teams: NURSE, SBAR, DESC, clear boundaries, and phone tips. Ready-to-use lines to de-escalate tension and restore cooperation.Empathy and disputes in healthcare: conflicts escalate over how patients are treated, not the technical detailsPractical scripts for clinicians to defuse conflicts: acknowledge emotion, share facts and uncertainty, set a clear plan with red flags, and follow up.Empathy with boundaries in healthcare: how to avoid the therapist or emotional rescuer roleLearn to show empathy while keeping clinical boundaries. Use brief scripts, 4S/STOP tools, and safety plans to guide tough visits.Burnout and Empathy in Medicine: The Feedback Loop and Fast On‑Shift ToolsBreak the loop: overload erodes empathy, poor rapport drives stress. Use 20–40s openers, micro-pauses, quick debriefs and clear boundaries when time is tight.Why bad news fails to reach the bossBad news can lose its urgency on the way to a manager. Learn about the MUM effect and how to report risks without stripping away their significance.Talking About Risk and Prognosis: No Panic, No False Hope in Clinical PracticePractical scripts for clinicians: natural frequencies, scenarios, ranges, safety nets, and teach-back to combine realism with humane, steady communication.Compassion fatigue in healthcare: protecting empathy without self‑sacrifice in everyday visitsPractical steps for clinicians: micro‑resets, clear boundaries, trigger maps, team debriefs, and red flags. Restore presence and empathy without self‑sacrifice.Walking the line between trust and boundaries: working with psychiatric patients while respecting their limitsPractical scripts to build trust and keep boundaries: partnership language, safety/choice de-escalation, and clear limits. Plus clear confidentiality.Medical taboos in the clinic: how to build a shame‑free atmosphere so patients can speak openly about symptomsPractical steps to lower patient shame: normalize concerns, use neutral language, add privacy cues, and offer clear next steps.“We don’t know yet”: how to talk honestly about diagnostic uncertainty without causing panicA practical playbook for discussing diagnostic uncertainty without alarming patients: normalize, use the 3×3 frame, set timelines and red flags.