The 4 C’s offer a number of ways that nurses can engage in and support communication with family members about serious illness.

Make sure clinicians and families discuss prognosis, goals of care, and palliative care.

Identify family needs for information, ensure that clinicians understand family perspectives, and ensure that clinicians clearly convey information that families want.

Identify emotions and respond to feelings.

Follow up after discussions to clarify and reinforce information and provide support.

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