Welcome back, I'm Kavita Ramchandran. We've discussed the importance of communication in our first modules. And I want to talk about something that I've learned in my practice as a way for us to remain grounded and focused in ourselves as we go through this course. We speak a lot in palliative care about being present and being able to be open. It is really important for the clinician to be grounded and centered in a way that allows us to be connected to the patient and family that's in front of us, while also allowing us to be able to be fully present for the situation that arises. To help with this, I'm going to talk a little bit about something called GRACE. It's a way for us to really see how providing care to others affects us, to be attuned to it, and to allow this process to help us to become better healers, while having compassion for ourselves. GRACE stands for a few things. G stands for, Gathering your attention. Gathering your attention is about gathering your attention in your body to be able to land ourselves in the here and now. It's about taking an inbreath and an outbreath a couple of times, focusing your breathing with your outbreath. Have that outbreath go through your abdomen, through your legs, and feel it in your feet. Feel it actually go to your feet, supporting you. Feeling grounded in your body helps you gather your attention. R is Recalling your intention. Think about your deepest intention, either as a clinician or as a caregiver, or as a human being. What was the point in time that you decided to pursue what you want to do next? For me, what was that in terms of being a doctor? Tap into that feeling of interest, or excitement, or whatever was happening for you when you made that decision. Really feel that in your body, a deep sense of an intention or passion. Have that feeling be your sustaining force as you go through your interactions with people in your clinical work. A feeling of intention, why am I doing this? A is Attuning or noticing, through your bodily sensations, your emotions and your thoughts. A is about tuning or noticing what is that you're feeling in both in your mind and body. Once you are aware and tuned into yourself and what you're experiencing the moment, consider the other person. What might they be experiencing? What can you tell from their emotional cues, body language, tone? Attuning into yourself and then others allows us to be open to the experiences in front of us with the patient, or their family, or other situations. C is Considering what will serve. Think about what is going to serve the particular situation that you're in, in the moment, or for the other person you're serving. Consider what is going to be the most benefit in this situation. Finally, E is Engaging and exiting. This means engaging in the interaction, ethically, fully, and with openness, then exiting this engagement in a way that allows you to mentally recognize the interaction is over. Exhale and then move forward. GRACE is a training that was developed by three people. Roshi Joan Halifax, a contemplative Zen priest who has worked in hospice and palliative care for many years. Tony Back, who many of you know is part of VitalTalk, has done a lot of work in communication. And he's an oncologist and palliative care doctor in Seattle. And Cindy Rushton, who is a nurse ethicist. They developed GRACE to provide a way for us to call ourselves back to ourselves, to be able to be present. The neuroscience behind it is that when we are able to be grounded in ourselves, it actually opens up the same neural networks for us to be able to experience empathy for another person. That is one of the huge benefits. Also, it's a way that supports resiliency for clinicians. We feel sustained, grounded, and motivated to continue to do the work that we're doing, while hopefully preventing fatigue or empathy fatigue.