Urgent Evoke

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People in the ER don't like it when I tell them it may take a while to see the doctor, but it calms them down all the same.

The ER is a pretty stressful place. But I've been there long enough to know that a lot of the stress is optional. It's the result of judgment, and of the withholding of information. When you judge a person in pain in whatever way - as "faking it," as "not having a real problem," they can sense it. And of course they can; we're social animals.

The best triage nurses I've seen have a remarkable ability to look at and talk to people directly. They can deliver bad news, they can tell you you're going to be waiting a while. They can tell you you're not going to be helped ("we can't give you that medication"). And you take it okay, because this person is sincerely telling you the lay of things. This person isn't judging you.

I think a lot of us read at least some of the 9/11 transcripts that came out. The hardest ones to read were the ones where the phone operator contradicted the caller about the situation or its significance. "It's not that bad." "You're going to be fine."

I think there are a lot of, from the outside, obvious social things about us that we, from the inside, are blind to. So - we're blind to the fact that others don't necessarily need a fix from us when they're in trouble. More likely, a distressed person is trying to orient in the context of warmth. In simpler language: the person who's dealing with the situation is going to deal with it. They're trying to regroup in the presence of a friendly other. "Friendly" doesn't mean "with the answer." Friendly doesn't mean, "is going to fix it for them." Friendly means, is going to let them acknowledge to themselves the thing they're experiencing, and not get in the way. The best 9/11 operators were able to listen to their callers. Just like the best triage nurses listen when you tell them where you are on the pain scale. And like, if I may include myself just a little bit in this amazing company, I try to listen when people tell me how they are.

The nature of crises is to cut off options. It's imperative not to cut off the people who are going to have to provide some kind of solution, for themselves if not for others.

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Comment by Calida DeBello on May 14, 2010 at 6:51pm
Great wisdom here. I especially like the point about withholding judgment, how key that is to getting the crisis under control...

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