Background An audit of hospital notes of inpatients diagnosed with advanced pancreatic cancer on a tertiary heptobiliary unit found little evidence of end of life discussions and advance care planning. While patients were often told at diagnosis that their cancer was incurable, they were generally not told their prognosis. Few nurses had formal communication skills training and most had little confidence in having end of life discussions.

Aims To examine outcomes of a two day interactive communications skills course on perceived self reflection of band 5 registered nurses.

Methods At the start and end of the course the nurses were asked to reflect on themselves as a communicator using three self awareness describers: Informer, Ignorer, Inquirer and to consider what patients required of them. Participants were asked to identify the communication challenges they had encountered and skills which may help their practice.

Results Over 80% of the 24 nurses identified themselves as Informers. Some said that at times they were aware that they ignored patient statements because they did not what to say and one said ignoring is the “only way to survive”.

Only two nurses identified themselves as inquirers, but they sometimes found this difficult and had both been “told about spending too long with patients”. The majority felt that their informer style matched patients' requirements.

Two main areas of challenge and specific skills development were identified: dealing with patients with difficult questions and dealing with and angry patients and relatives.

Following the course all participants said that they would be primarily an inquirer. The skills of listening, pausing, summarising and empathy were evaluated as the most useful enhanced skills. Confidence and knowledge increased in the specific challenges that were identified.

Conclusion A two day interactive course may promote awareness, increase confidence and may enable change practice.