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Elaine Wittenberg

, Joy V. Goldsmith

, Sandra L. Ragan

, and Terri Ann Parnell

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date: 20 April 2021

Openings offers specific tools to assist the nurse in traversing the challenging yet profoundly rewarding moments of transition that require the clinical practice of intimate openings with the patient/family. Replacing evasion with an opportunity to move into tension and avoidance is essential in helping a patient/family receive palliative care. Observations of tension might be clear indications of a needed transition in care. Complex interactions with patients and families coincide with transitions in care and require intimate and disclosive exchanges among patient/family and nurses. Communication privacy management theory helps us understand more about private information and how that information depends on the relationship people share. Communicating a transition to palliative care from hospital to home or to end-of-life care and hospice requires nurses to address a patient’s/family’s fears and feelings of hopelessness and to provide education about palliative care and its services. Facilitating appropriate access to private health information, creating intimate openings to process transitions in life and care, and understanding the impact of disclosure on patient/family relationships all play an important role.

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