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A profession is partially defined by its culture and the esoteric language it may use. We see this even within medical specialties. OB/GYN uses their “G’s” and “P’s” and neurointensivist and neurosurgeons use their “PBD# POD# HH# MF#” phraseology to efficiently communicate elements of a subarachnoid hemorrhage patient. If we put the OB/GYN and neurosurgeon in the same room, they each will have to think back to med school to figure out what the other is trying to communicate. While this nomenclature is done for efficiency, we ought to be careful for phrases that we use in front of patients and their families, especially with end-of-life disuccsions. We may say, “Withdrawal of care” or just “withdrawal” while what we truly mean is to withdraw life sustaining therapy, but still provide comfort measures. Even worse, physicians will use the crass term “pull the plug” as if people were machines similar to the technology that is supporting them. While our intent may be to communicate efficiently and directly, we must consider how these phrases sound to patients and their families. The contrarian would retort, “Certainly we would never say these things around patients, we just use them with other physicians.” However, next time you are in the ICU and someone else is speaking to other providers or speaking to a family, just watch. People are listening and people are watching our body language. They know when we are discussing a negative turn of events and they interpret our words through their own experience. If we want to consistently communicate the message to families that we are withdrawing life sustaining measures or we are changing the goal to comfort care measures, we should use these phrases with other medical providers. We may think that we are alone, but we are not, they are listening. Consider the term “futile.” Every intensivist uses this term and might be familiar with the discourse on medical futility and inappropriate treatments. Now imagine how that word sounds to the family of a dying patient, even to the family who knows that any hope of recovery is lost. Please be careful, they are listening. “They Are Listening” By Michael Rubin, MD, MA 18 WHAT IS PONS? PONS is a curriculum-based eLearning series comprised of various neuropharmacotherapy topics presented by experts in the fi eld of Neurocritical care. PONS presentations are 60 minute webinar recordings that can be viewed at your own pace. Presentations can be purchased individually or bundled. PONS can be used as a review for healthcare professionals, to facilitate topic discussions among trainees, or as a group educational lecture series. Each session includes a library of annotated references used during the presentation. AUDIENCE PONS targets a wide range of disciplines including physicians, nurses, pharmacists and more. The series benefi ts individuals practicing in all medical disciplines, particularly those who want to further their neuropharmacotherapy knowledge. It is also an innovative tool to help educate trainees. TOPICS INCLUDE: • Acute Blood Pressure Control Following Intracerebral Hemorrhage • Antithrombotic Reversal in Patients with Intracranial Hemorrhage: A Review of the Guidelines • Diabetes Insipidus • Get it in your head! Introduction to Intraventricular and Intrathecal Drug Delivery • Hyponatremia • ICU Management of Myasthenia Gravis: This Weakness is Getting on My Nerves • Management of Status Epilepticus: Breaking Bad! • Osmotic Therapy for Elevated Intracranial Pressure • Paroxysmal Sympathetic Hyperactivity • Targeted Temperature Management (TTM) E‰ ects on Drugs and Shiver Control • Venous Thromboembolism Prophylaxis: Translating Evidence into Clinical Practice • Wading in the Weeds: Cannabis Use in the Hospital ACCREDITED FOR CONTINUING EDUCATION FOR PHARMACISTS, NURSES AND PHYSICIANS! Access PONS at: www.pathlms.com/ncs-ondemand/courses/1622


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