Communication skills and district nurses: examples in palliative care.

This article discusses some communication skills that may be challenging for district nurses who are working with palliative care patients. The article suggests that assessing what the patient knows about their illness is a key factor to effective communication. It pays particular attention to the first visit made by the district nurse. The article also discusses some specific situations that the district nurse may encounter, such as answering direct patient questions, denial, collusion and anger. A framework of communication styles developed by Wilkinson is used to understand the responses that may be given in such challenging situations.