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Emotion is always present in critical conversations. When we recognize emotion, validate feelings and respond with empathy and curiosity, we allow patients and their families to engage in the process, to build trust, and to better understand their values. When emotions are too intense, or feelings are not validated, people become disengaged, less trusting, and often fail to explore and understand the deeper values‚ and instead may act on raw, surface emotions that actually may not be in their best interest.

We often answer feelings with facts. Instead, we should G.I.V.E. when we encounter emotion. G.I.V.E. is a mnemonic tool that offers a simple approach to responding when emotion arises in conversations.

First, get that there is emotion present and pause. Identify what you think the emotion might be or describe what behaviors you are noticing. Validate the feelings expressed. Explore to understand better and offer your curiosity and caring.

And if you can’t remember what G.I.V.E. is prompting you to do, it may be enough to give your attention and patience to the other person in that moment.

Laura Rock

Dr. Laura Rock is a Pulmonologist, Intensivist and Director of Communication and Teamwork for critical care at Beth Israel Deaconess Medical Center in Boston, MA, an Assistant Professor at Harvard Medical School, faculty for the Center for Medical Simulation and a VitalTalk instructor. Dr. Rock studies and teaches the role of emotion in critical conversations, debriefing, feedback, and interprofessional conflict negotiation. She thinks we can change the world one conversation at a time, when we truly listen, and when we allow for creative and collaborative possibilities. When not teaching or seeing patients in the ICU, Dr. Rock loves to spend time with her family and hike, ski, mountain bike, surf and sing.

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