BY EMMA MURRAY

As a medical professional who grew up navigating the healthcare system with a diagnoses of Cerebral Palsy, a patent foramen ovale (PFO), atrial septal defect (ASD), and ventricular septal defect (VSD), I have experienced complex medical conversations from both sides of the exam room. These conversations—moments when providers must deliver complicated or difficult news—shape how families understand, cope, and advocate for their child’s care. Reflecting on my experiences as a child, a nursing student, and now as a nurse practitioner with specialized training in emergency medicine, I’ve seen firsthand the critical gaps in how providers approach these conversations.

When I was diagnosed with Cerebral Palsy as a young child, my parents’ introduction to this lifelong condition came from a physician who casually stated, “Your child is fine with the exception of her Cerebral Palsy.” That statement, though perhaps intended to minimize fear, fell painfully short of addressing the complexity of the diagnosis or providing the compassionate support my family needed. Those words lingered not because they were helpful but because they felt dismissive, leaving my parents to process their emotions and seek clarity largely on their own.

That experience, and others like it, deeply influenced my decision to become a healthcare provider. I wanted to be the type of clinician who could guide families through moments of uncertainty with clarity, empathy, and respect. I pursued nursing and eventually became a nurse practitioner, completing a fellowship in emergency medicine where I encountered some of the most challenging conversations providers and families can face. It was in this setting that I saw the importance of not only what providers say but how they say it.

The Patient Perspective

As a child navigating life with a complex medical history, I quickly learned that the way information is presented matters as much as the content itself. Providers who treated my parents and me with respect, took the time to explain things clearly, and validated our concerns made us feel empowered. These were the moments that fostered trust and gave us the confidence to make informed decisions. On the other hand, rushed or dismissive interactions—like the one surrounding my Cerebral Palsy diagnosis—left my parents feeling confused, unsupported, and even reluctant to ask follow-up questions.

The best providers were those who didn’t just talk at my parents but instead invited them into the conversation. They provided space for their questions, acknowledged the emotional weight of the moment, and offered resources to help us navigate the journey ahead. It wasn’t just about delivering information—it was about making us feel seen, heard, and respected.

The Provider Perspective

As a nurse practitioner, I’ve had the privilege of standing on the other side of these conversations. Through my fellowship in emergency medicine, I witnessed and participated in some of the most emotionally charged moments families experience. Whether it was discussing the results of a traumatic injury, addressing a life-changing diagnosis, or guiding families through end-of-life decisions, I quickly realized how critical it is to strike a balance between delivering facts and offering compassion.

I’ve seen providers who handled these conversations beautifully, breaking down complex medical jargon into understandable terms while acknowledging the family’s emotions and creating space for their questions. I’ve also witnessed, and admittedly experienced myself, moments where the delivery fell short—where time pressures, emotional fatigue, or lack of training made the conversation feel impersonal or rushed.

Emergency medicine is unique in that the stakes are often high, and decisions need to be made quickly. But even in these high-pressure environments, there are ways to approach families with empathy and clarity. I’ve learned that it’s not enough to share information; providers must also validate the family’s experience and offer support, even when the news is difficult.

Where the Gaps Lie

Despite the critical importance of these conversations, healthcare providers often receive little formal training in how to navigate them effectively. Medical education prioritizes diagnosis and treatment, but communication—especially complex, emotionally charged communication—is rarely given the attention it deserves. As a result, providers often rely on instinct or personal experience, which can vary widely in quality.

Parents, too, are often left to bridge this gap themselves. They’re expected to advocate for their child, ask the right questions, and make informed decisions, all while processing what can be overwhelming or devastating news. The result is a system where families and providers sometimes feel like they’re working against each other, rather than together, in the child’s best interest.

Why Parents Are the Key

Through all of this, one constant has stood out: parents are the most important advocates for their children. As a provider, I’ve seen time and again how a parent’s intuition, persistence, and willingness to ask tough questions can change the course of a child’s care. Parents know their child better than anyone else, and their insights are invaluable in helping providers understand the full picture.

When faced with difficult news or decisions, it’s essential to feel empowered to ask for clarification, seek second opinions, or request more time to process the information. A good provider will welcome questions and work with you to find the best path forward. If something doesn’t feel right, trust your instincts and speak up. Your role as an advocate is not only critical but also respected by the vast majority of healthcare providers.

Improving the System

While parents play a vital role, the responsibility to improve these conversations doesn’t fall solely on their shoulders. The healthcare system needs to invest in better resources and training for providers to navigate complex conversations effectively. This includes workshops on compassionate communication, access to mental health and social work support for families, and protocols that allow for adequate time to discuss challenging topics, even in busy settings.

Providers must also recognize that empathy and listening are as important as medical expertise. Taking the time to sit down, make eye contact, and ensure that families feel heard can make all the difference. It’s not about having all the answers but about being a partner in the family’s journey.

Moving Forward Together

As someone who has lived both sides of the patient-provider relationship, I know how daunting complex medical conversations can be. I also know how transformative they can be when handled with care and respect. My hope is that by sharing my story, I can inspire both parents and providers to approach these moments with greater empathy, patience, and collaboration.

• To parents: You are your child’s greatest advocate. Never hesitate to ask questions, seek clarity, or push for the care your child deserves. Trust your instincts and remember that you are an essential part of the care team.
• To providers: Remember that every word you say in these moments matters. Families will remember how you made them feel long after they’ve forgotten the details of the conversation. Approach these discussions with humility, empathy, and a commitment to partnership.

Together, we can bridge the gaps in complex medical conversations and ensure that every family feels supported, respected, and empowered. These moments are not just opportunities to deliver care—they’re opportunities to build trust and make a lasting difference.

Emma Murray is a dedicated nurse practitioner, born and raised in Rhode Island.  Her diagnosis of cerebral palsy has shaped her passion for advocating for children and families facing complex medical needs. She strives to make a difference both in her work and community through compassionate care and meaningful advocacy. Outside of work, she finds joy in volunteering and giving back to causes close to her heart.