Empowering Primary Care Provider Engagement in Difficult Conversations

Nurse practitioners positioned as primary care providers (PCPs) across various settings frequently face difficult and serious topics that require addressing with patients and families. Limited practical guidance exists to help PCPs prepare for these difficult encounters. The SPIKES (Setting up, Perception, Invitation, Knowledge, Emotions/Empathy, and Strategy/Summary) framework and the NURSE (Name, Understand, Respond, Support, and Explanation) tool are presented to assist PCPs in (1) facilitating difficult conversations, (2) incorporating patient preferences and values as a central component of evidence-based practice, and (3) ensuring appropriate follow-up and debriefing, aimed at improving outcomes of health care conversations.