Background COVID-19 changed healthcare working practices. Communication with patients and their families moved from face-to-face to primarily remote contact; communication skills had to adapt.

Aim To understand palliative community nurses’ lived experiences when completing advance care planning (ACP) face-to-face, compared to telephone.

Method Using reflective stories, the author attempted to understand what influences the way ACP is raised both face-to-face and over the telephone. Themes were then compared to understand if one approach is more effective. University and organisational ethical approval was obtained prior to commencing the study. Written consent from participants was obtained prior to the interviews being undertaken. The sample consisted of community nursing team staff, with ward-based staff and those with less than two years’ organisational experience excluded.

Results Seven semi-structured interviews were conducted, three face-to-face and four conducted virtually over a meetings platform. Face-to-face ACP is preferred, as the telephone can be a barrier to the discussion, with a lack of non-verbal prompts potentially causing distress as professionals are unable to react to cues. Family input remains important. However, in face-to-face communication, personal protective equipment can be a barrier for those with a hearing impairment.

Conclusion Participants identified that ACP discussions can be affected by methods of communication. Although no substitute for face-to-face discussions, this study shows the telephone may provide a viable alternative to begin ACP discussions. The author recommends a study looking at the patient lived experience of ACP discussions, comparing face-to-face to telephone discussions. The potential future development of an ACP information pathway e.g. an online information portal, could offer an enhanced and patient-centred approach to telephone ACP discussions between professionals, patients and relatives.