15 super powers you never knew you had
15 super powers you never knew you had
Introducing your guide’s on this Every day Hero journey: Toby Campbell; MD Christine Monahan; MSW Carolyn Strubel; HD
Objectives
• Develop personal confidence in architecting conversations with families facing a death
• Define & practice your super power when discussing end of life decisions
• Design your super powers around openings to these conversations
• Design your super powers to help families transition in their understanding around grave prognosis/death
Super powers
• Empathy • Healing strength • Leadership • Truth (lasso of truth) • Super speed • Messages (good or bad) • Fairness • Loving of Peace
• Communication skills • Longevity • Wisdom • Courage • Endurance • Enhanced Hearing • Heart • Everyday Hero
Agenda: Hero’s among us
• “Yes Let’s”: Guardians of the Gift
• Ranting: Why consider it a Super
Power
• SPIKES/NURSE: WHO YOU ARE WHAT YOU DO – Everyday hero’s
• Brain storm/responding to emotion: Openings & Transitions: Icon, Valor, Illuminator, Fortitude, Innovation, Idol, HERO’S
“Yes, Let’s”
The 2 minute Rant
SPIKES/NURSE
• S Set the Scene • P Understand Perception • I Get and Invitation • K Share Knowledge • E Empathetic Statements • S Summarize and Strategize
• N Name the Emotion • U Understanding Statements • R Respecting and praising • S Supporting Statements • E Exploring Statements
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Setting the Scene
Scene: basics • Your name, role and
relationship – “My name is
_______________ – Greeting to everyone in the
room
• Sit, whenever possible • Make Connection
Understand their Perception
Perception • Where are we and where
are we going? – First: Understand – Second: Guide
• Test the Hypothesis: – This family understands
the illness accurately.
• Disclaimer followed by a open-ended question – “Can you tell me your
understanding about what the doctor/nurse has told you?”
• Hopes and Goals: Agendas – “Are there things you want
to make sure we discuss today?”
– “What other questions do you have?”
Get an Invitation
• “Is now an okay time to talk?”
• “Would you like to talk about what this means?”
• “It’s not the news we were hoping for.” – “we didn’t find an
answer for…..” – “there are some areas in
question I need to investigate further.”
• “I have bad news.”
Warning Shot
Share Your Knowledge • Just the facts, simple and
straight forward and brief. – “The Apnea test shows …..” – “The clinical exam
shows…” – “Your father has had a
heart attack.” • Give your sentence a
period. – Silence is an active process,
a decision you make to create space for processing.
Empathetic Statements • Name: “I can see…” • Praise: “You’ve done all
we asked.” • Explore: “Tell me more
about…” • “I wish there were
something else…”
Summarize & Strategize
Motivational Interviewing
• O Open-ended Questions
• A Affirmations
• R Reflective Listening
• S Summaries
Brain Storm/responding to emotion • Openings
– Components of a conversation
– Skill vs. Mastery Demonstration
• Transitions – Using language to assist
family • Demonstrations
Seeking Mastery • Novice • Advanced Beginner • Competent • Proficient • Expert • Master
• Reliant on rules/guidelines
• Conceptual Models Frameworks in context of big picture
• What distinguishes the Master from the Expert?
Dreyfus Model of Skill Acquisition, Hubert and Stuart Dreyfus, 1986
Seeking Mastery
What distinguishes Master and Expert?
• The Expert – Knows -- Intuitively does what works – Identifies and solves problems
• The Master – Has developed personal style – like an artist – Welcomes
• novelty, challenge and experimentation • opportunities to re-examine assumptions & explore new paths
Superpowers Brainstorm
Good ways to open a difficult conversation
Superpowers Brainstorm
Good transition phrases
Superpowers Brainstorm
Talking about dying
Take Home Points
• SPIKES • NURSE • Opening and Transition Great Questions • Phrasing to Talk about Dying • Individual Action Plan
