R—Relating

Relating is a chapter that unpacks the complex architecture of goals always at play for each of us. Because the true motives and goals of a patient are rarely fully understood or realized, the recommendation in this chapter is to attend to the relationship to facilitate the instrumental goals of palliative nursing. Throughout this chapter, authors examine the phenomenon of the patient/family acceptance of an illness status, as well as understanding patient/family perspectives on adjusting to new information. The authors examine the role of uncertainty and how it can impact goals of care discussions and, ultimately, decision-making. Relating to a patient/family creates the opportunity to learn about acceptability of a diagnosis/prognosis, fears associated with uncertainty, and the inevitable dissonance among personal goals in the face of serious illness. Multiple, conflicted, and unrealized goals are a reality that clinicians must navigate and that patients and families must face as they work together to acknowledge a changing life and identity.