Comms Lab: Respect

Comms Lab: Episode 9

5 things I’ve Learned About Using Respect, Praise and Appreciation to Build Relationships in the ED

Expressing respect, praise and appreciation should be simple, but we’ve all had experiences where it’s gone wrong.

It’s all too easy for our good intentions to be misinterpreted.

So how do we avoid these pitfalls?

How do we make the most of our appreciation to really build relationships?

And what role do these skills have in our difficult conversations?

This is the third video of a series on the NURSE acronym, a set of well-studied tools for responding to emotion

In this week’s video, I discuss the 5 most important things I’ve learned about how to express Respect, Praise and Appreciation, and provide specific guidance on how we can integrate these skills into our work and life.

Thanks for watching:)

0:00 – The emotional super-power
0:27 – “I love you, man.
0:54One: Sometimes, the one thing that a person needs…
1: 14Two: Don’t miss an opportunity…
3:27Three: Focus on intention and courage…
4:30Four: Maximise the impact…
5:26Five: People do more of what you thank them for…

NURSE acronym **

Name the Emotion; Normalising for the Population“It seems like this whole situation has left you feeling pretty frustrated.”
Understand the Driver (Behind the Emotion)“You’ve been through a huge ordeal today. I can only imagine it must have been incredibly scary for you.”
Respect, Praise, and Appreciation“You’ve done an amazing job looking after your Mum. It can’t have been easy.”
Supportive Statements“I’m here to look after you. It’s really important to me that we relieve your pain as best we can.”
Explore the Story“What was that like? Tell me more.”

** There are many iterations of the NURSE acronym with alternative wordings, depending on your source, though they all generally refer to the same skills. I intentionally take “the patient” out of the wording of the skills as I see the elements as broadly generalizable skills for responding to emotion, even outside the clinical context.


Comms Lab

A path to highly effective communication skills

Dr Hayden Richards LITFL Author Comms Lab

Hayden is an emergency physician at University Hospital Geelong and a senior lecturer at Deakin University, Geelong. He is somewhat obsessed with the science and art of effective communication, and in particular: difficult conversations. He believes that we can all get better at having difficult conversations, and that the process of learning to do so can be seriously fun.

Hayden is also an avid but terrible surfer, ad hoc gardener, and dad to two awesome kids. | LinkedIn |


  1. The last one, Explore the Story “What was that like? Tell me more.” is good for professorial rounds, not practical in a busy ED.
    Try changing that to Explore the Expectations. “What do you expect will happen, what can we do for you or your loved one, to help recover from the stroke, surgery, heart attack, etc”
    Go Cats!

    • Thanks for your comment Honiara Hooligan:) I love your suggestions re. exploring expectations. I find that one of the most common causes of miscommunication or poor interactions is a mismatch in expectations, so having these out on the table is hugely valuable.

      A lot of people worry about using super-open questions like, “What was that like? Tell me more.” The common belief is that it will result in opening a “can of worms” and lead to an extended, unproductive monologue from the patient. That can happen, so I agree that there is a time and place for these kinds of questions, but think it would be a huge shame to relegate them to “professorial rounds”. It may be counter-intuitive, but my experience in the ED (even a busy one) is that these kinds of skills have greatly increased my productivity.

      Thanks again for your engagement – you’ve given me a great idea for a future video – stay tuned:)

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