Mastering Intensive Care 048 with Laura Rock

Communication is perhaps the most important thing we do in healthcare, let alone in life. And to support our patients in understanding their ill health and their healthcare needs requires a high level of human connection for communication to be optimal.

So let me introduce you to Dr Laura Rock, an American intensivist, who reminds us on this podcast that

• communication skills are learnable,
• there are benefits in understanding our patients emotionally,
• we can help patients greatly if we don’t try to reassure with facts when we hear emotions in the words they use, and
• a focus on transparency, respect and curiosity can help us all to understand each other better; all of which seem likely to help us in our roles in the Intensive Care Unit.

Questions we address include: Are you a good communicator? Can you identify the skills of optimal communication? Might you sometimes respond to emotion with facts?

Laura is a Pulmonologist, Intensivist and Director of Communication and Teamwork for Critical Care at Beth Israel Deaconess Medical Center in Boston, Massachusetts, an Assistant Professor at Harvard Medical School, Faculty for the Center for Medical Simulation and a VitalTalk instructor. Laura 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, Laura loves to spend time with her family and to hike, ski, mountain bike, surf and sing.

In this episode you will hear Laura speaking about many aspects of communication, also including:

• How she got into critical care and then became focused on communication
• What good communicators do to make human connection
• How micro-encounters and casual interactions are all part of building trust
• The GIVE acronym she suggests for responding to people’s emotions (Get there is emotion, Identify the emotion, Validate the feelings, Explore to understand)
• Some examples of how to respond to what sound like comments with emotions
• Some thoughts on what to do when the person is angry
• How we should guess at people’s emotions, not tell them what they are feeling
• Her thoughts on touch including hugs
• How the universality of communication skills can help us with friends and family too
• Being specific when helping debrief a team
• The teaching she does on ward rounds
• How most poor communication interactions can be helped by saying sorry
• Her self care including her approach to exercise, nature, guitar-playing, sleep and balance
• The gratitude she feels for having recently spent a lot of time with her dying mother.

Laura is kind, caring, astute, thoughtful and the sort of listener and communicator I would have liked to have been involved in the care of my father when he was dying, something we talk about towards the end of the episode.

This one is really worth listening to, no matter how good you think your communication skills are. Please listen to and learn from Dr Laura Rock.

People, organisations and resources mentioned in the episode:

• Laura Rock on Twitter; Harvard Catalyst; LinkedIn; Beth Israel Deaconess Medical Center
• Persevering: Sick of COVID
• Center For Medical Simulation
• VitalTalk
• Published papers by Tony Back and Bob Arnold
• 2019 World Congress of Intensive Care Medicine
• Melbourne marathon 
• Melbourne Cricket Ground
• MIC Podcast 047 with Matt Morgan

Further reading and listening

• Full podcast collection on LITFL and Libsyn
• The New Normal Project podcast
• More conversation on Twitter (@andrewdavies66) and Facebook