The AMEN Protocol: Bridging the Gap between Hope, Faith and Healthcare Providers (highlights from Kathrynn Thompson)

I recently read an article on the AMEN protocol and found it very interesting. Here are some of the highlights.

The AMEN protocol was developed to help healthcare providers stay engaged with their patients and their families during difficult conversations that involve the spiritual or religious beliefs. Often these conversations are about a poor prognosis or end of life.  Often times,  the patient and family are hoping for a miracle.

A= Affirm the patient’s/family’s belief, provide validation of their position:  “Mr. L. I am hopeful too.”

M= Meet the patient/family where they are emotionally/spiritually:  “I also hope you will be healed.” or “I am praying for your healing as well.”

E= Educate from your position as a healthcare provider (nurse, doctor, etc.): “And I want to talk to you about some medical/nursing issues.”

N= No matter what assure the patient/family that you are committed to caring for them.  “I will be with you every step of the way, no matter what you decide to do.”

The AMEN tool helps to normalize these discussions and reframe these conversations into ones of hope. This can decrease the chances of misunderstanding and resistance. Misunderstandings often flow from the differences in belief systems between the patient/family and the healthcare providers. At times providers may put themselves in direct competition with the patient’s/family’s higher power. For example, beware the word “but”. When we add the word “but” to a statement about hope or miracles the patient/family can feel dismissed and we put ourselves in competition with their higher power.  We need to join with the patient/family rather than appear to dismiss their beliefs. That does not mean we cannot share our medical/nursing expertise. It’s all in the wording.  Dependent on your beliefs it may helpful to say. “I firmly believe it is Gods role to create miracles and my role is to share important nursing/medical information to help with your decision-making.”


All content comes directly from the article, “AMEN in Challenging Conversations: Bridging the Gaps Between Faith, Hope and Medicine” by Rhonda Cooper, Anna Ferguson, Joann Bodurtha and Thomas Smith in the American Society of Clinical Nursing (2014).