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Arzellra Walters, RN, CPNP
Mount Sinai, NY

arzellra waltersLet's take a moment to think about communication in the pediatric transplant world. No, I am not talking about intra-atrial communication of atrial septal defects for all of you pediatric cardiac professionals out there. I am talking about communication between the child (the patient), care giver and health care professional (HCP).

Patient-HCP communication is important in all age groups. However, in pediatrics it is especially important. When time is taken to build a rapport with, and understand, the patient and family, trust is built. Within the world of transplant, effective dialogue between patient, family and HCP is crucial to patient survival because it leads to improved patient knowledge, functional status and adherence to the agreed-upon treatment regimen. defines communication as "a process by which information is exchanged between individuals through a common system of symbols, signs or behavior." Communication should be in a language that patients/caretaker can understand and the communicator should have interpersonal sensitivity. In addition, communication must be constant and reciprocal.

In order for patients to effectively communicate with HCPs, the language used must be one that the patient and caregiver can understand. This means one should take the time to explain everything in lay-person and age-appropriate terms. As much as possible, information should also be provided in written format. HCPs need to be sure that the information is always provided in a calm, quiet environment whenever possible. In order to dispel myths, HCPs need to set aside time for questions from the patient and caretaker. Information should be provided on a continual basis to avoid any misunderstandings. Finally, the exchange of information must be reciprocal. HCPs should always listen to the patient and family concerns and questions. Often, a small bit of insight from a family member can make the care of the patient easier.

Another concern with patient-family-HCP communication is the method used. As much as possible, communication regarding life-changing situations should happen face-to-face. However, in this age of technology there are now several ways to communicate. What is being communicated will help dictate how it is communicated. All of these principles should be followed whether you are talking to a pre-transplant family being evaluated for transplant or a post-transplant family whose child is undergoing yet another biopsy to rule out rejection.

Communication with the pediatric transplant family is like the childhood story of The Three Little Pigs. Piggy number one built his house of straw and Piggy number two built his house of wood but sure enough that Big Bad Wolf came and blew down both those houses. Well Piggy number three was smart and built his house of brick. Try and try as he might the Big Bad Wolf couldn't blow that house down. Let us all be like Piggy number three and build our "house of communication" like a house bricks so that nothing can tear it down!

As the New Year begins, let us all review our communication methods and find what works best for patients and you!

Disclosure Statement: The author has no conflicts of interest to disclose.