Memorable conversations in neonatal intensive care: A qualitative analysis of interprofessional provider perspectives

Objective: In this study, we explored the providers’ perspective of difficult conversations in neonatal critical care. Methods: Between 2008 and 2011, interprofessional neonatal providers voluntarily attended the Program to Enhance Relational and Communication Skills-NICU workshops at Boston Children’s Hospital. We analyzed seventy-four participant narratives that described a difficult conversation in the NICU that was particularly challenging or satisfying. Results: Participants described memorable conversations that were exclusively challenging (n = 51), both challenging and satisfying (n = 22), and exclusively satisfying (n = 1). We identified five broad domains (Infant’s Clinical Situation, Family Characteristics, Provider Characteristics, the Provider-Family Relationship, and Satisfying Elements) and several themes that further characterized the providers’ perspectives. Conclusion: Understanding the practitioners’ experience with difficult conversations may help staff to anticipate some challenges inherent in neonatal discussions and to design communication and relational learning educational efforts.