Years ago, I attended a great seminar on the subject of stress, given by a speaker who was a Psychologist. The Psychologist made a statement that forever changed my perspective on Patients.
He said, "All Patients are Type C and all Type C's are victims".
The speaker illustrated this point by saying that the Patients are victims of an accident, illness or disease, whether due to a smite by the hands of The Fates, or because of their own self-destructive actions.
He encouraged us to start viewing all the Patients that we serve as victims in order to raise our consciousness in understanding their responses to their situation. With that understanding, we would be able to better deal with their behavior.
We easily feel empathy when an injury affects a Type C child, yet feel some apathy when a Type C adult suffers the ramifications of their imprudent inaction or self-destructive actions. Both or either could be our Patient, and it is our duty to provide quality care in an objective manner.
Providing care in an objective manner isn't easy when our emotions are triggered. We will easily kiss the boo-boo if a child, yet feel righteousness in chastising the behavior of a treatment non-compliment adult.
These are thoughts that I wanted to express and will pause before continuing.
In the meantime, please share your thoughts, if you will.
Specializes in Psych (25 years), Medical (15 years).
1 hour ago, JKL33 said:
Nurse is called upon to display great empathy, which can amount to the appearance of excusing the behavior. Nurse secretly feels like 2nd victim because abuse and aggression doesn't need to be enabled...
And, as psych Nurses, we are instructed not to confront a Patient's behavior, because confrontation is interpreted as a sign of aggression.
Instead of using the word confrontation, we can document interventions described as "instructed, informed, or guided" to appropriate behavior.
In essence, we are confronting the Patient's behavior, but are doing so in a less aggressive manner. One method in not aggressively confronting behavior is to avoid using the word "you" or the word "should".
Using statement such as "You did this" and "You should do this" are aggressive statements- such statements which are regularly used on these forums.
Using the word you is symbolically akin to thumping the receiver in the chest. Using the word should is button-pushing, and the sender is seen as the mean Parent.
Instead of the word you, using the word "we" is less aggressive. The word you is singular and stands vulnerably alone. The word we is plural and is interpreted as a sort of togetherness, and has more power.
Instead of using the word should, the word "need" is also less aggressive.
For example, in confronting (guiding) a Patient who is manifesting inappropriate behavior, we could say something like, "Doing so and so is inappropriate, and we want to be appropriate, so we need to do so and so".
While guiding the Patient toward more appropriate behavior, subtle, visual clues are important. For example, while stating "we want to be appropriate", we nod our heads. This action is positively interpreted as a "yes", and the receiver is more drawn to what we are saying.
And, as psych Nurses, we are instructed not to confront a Patient's behavior, because confrontation is interpreted as a sign of aggression.
Instead of using the word confrontation, we can document interventions described as "instructed, informed, or guided" to appropriate behavior.
In essence, we are confronting the Patient's behavior, but are doing so in a less aggressive manner. One method in not aggressively confronting behavior is to avoid using the word "you" or the word "should".
Using statement such as "You did this" and "You should do this" are aggressive statements- such statements which are regularly used on these forums.
Using the word you is symbolically akin to thumping the receiver in the chest. Using the word should is button-pushing, and the sender is seen as the mean Parent.
Instead of the word you, using the word "we" is less aggressive. The word you is singular and stands vulnerably alone. The word we is plural and is interpreted as a sort of togetherness, and has more power.
Instead of using the word should, the word "need" is also less aggressive.
For example, in confronting (guiding) a Patient who is manifesting inappropriate behavior, we could say something like, "Doing so and so is inappropriate, and we want to be appropriate, so we need to do so and so".
While guiding the Patient toward more appropriate behavior, subtle, visual clues are important. For example, while stating "we want to be appropriate", we nod our heads. This action is positively interpreted as a "yes", and the receiver is more drawn to what we are saying.
Tried and true techniques.
I actually wonder about this?
Modern world, antibiotics in everything.... huge rise in immune related pathologies.... Allergies etc.
Memories? Fear.... why do those memories always make a bigger impact?
Theories from academics that spent years in academia and how many psychologists and Psychiatrists appear 'normal'? Think any have walked into a bar and 'scored' HOW SANITIZED are their experiences that can resonate with 'normal' Joe the Plumber?
Should you actually take directions from a blind man or is his perspective too different? Does a bat actually see like us? Not from the sonar pics I've seen? America is quite unique because of its isolation and Hollywood influences. Take this as gospel! A commandment! We live a Jetsons culture! No one else DOES!
The rest of the world actually live similar lives. We resist universal health care. Spend instead of save. Borrow money through our history of borrowing money, 'credit score'? If the rest of the world is from Mars, we are Venutians!
They will bluntly tell you certain truths or tactfully tell you the truth! Operative word is the TRUTH!
Does advice or directions from an academic whose entire life was spent in a cloistered environment actually resonate with the real world? HAVE THEY LIVED IN THE REAL WORLD?
I appreciate the sentiment behind the idea, as it is meant to increase empathy and compassion in our response as nurses.
In general, I agree with this - but it can also cross the line into enabling. I am someone who has struggled with an alcoholic family member, and this individual committed suicide. So I have seen very painfully, and very first hand - the destruction that is caused by poor lifestyle choices and addiction.
I have pondered this AT GREAT LENGTH, as you can imagine, because this person was significant in my life and had a HUGE affect on me and my future.
I empathize with his choices, his impulsivity, perhaps he truly had no control over his addiction. In the end, it cost him his life. It cost me a great deal as well. I paid a very high price for the choices he made (that I had no control over).
I dislike the term "victim" and I will NEVER use that to describe myself. EVER. I am a victim of nothing. I have faced challenges, but they do not define me. If someone else likes that term - they can claim it. But it isn't my story. I am the hero, not the victim of my circumstances. This is what I choose.
Should we let people off the hook for their poor choices? As I look back on the person in my life who was affected by addiction - I do recognize that there was something in him that - but for the grace of God - I do not have. I get terrible headaches when I drink and I simply don't have an addictive personality. Perhaps he lacked grounding in solid principles. I don't know.
Do I feel he was in any way culpable? Yes. I honestly do. I struggle with anger against this person. Is he a victim? Probably on some level - I don't really know what was going on in his Inner World that lead him to these choices. It wasn't just one choice. It was choice after choice after choice.
In terms of "judging" people for their choices - I can tell you, at this point in my personal life - I keep a distance from people I do who are not "SAFE" people. In my professional life - I can absolutely feel empathy for those struggling with addiction.
It's probably easier for me to feel empathy for someone out on the streets with a heroin or alcohol addiction - when I am not directly affected by their actions.
I remember praying to God that SOMEONE, ANYONE would hold him accountable. I used to PRAY he would get a DUI - he drove drunk all the time. Please someone pull him over so he can FINALLY OWN his addiction and take responsibility for his actions. Please let him lose his wallet or SOMETHING so that he realizes he can't live his life so irresponsibly.
I have been granted many privileges in life and ultimately I am grateful for what I have been given. It is up to me to use my opportunities for Good. It's like Darth Vader - I can choose the light side or the dark side. I choose the Light. Every single one of us has this choice. If someone feels "judgment" because they are an Addict - it's possible that having some level of social pressure or social stigma - may not necessarily be a bad thing.
That is a very long way of saying ... it's a very nice, compassionate sentiment - but it's OK to hold people accountable for their actions as well.
Davey Do
10,666 Posts
And, as psych Nurses, we are instructed not to confront a Patient's behavior, because confrontation is interpreted as a sign of aggression.
Instead of using the word confrontation, we can document interventions described as "instructed, informed, or guided" to appropriate behavior.
In essence, we are confronting the Patient's behavior, but are doing so in a less aggressive manner. One method in not aggressively confronting behavior is to avoid using the word "you" or the word "should".
Using statement such as "You did this" and "You should do this" are aggressive statements- such statements which are regularly used on these forums.
Using the word you is symbolically akin to thumping the receiver in the chest. Using the word should is button-pushing, and the sender is seen as the mean Parent.
Instead of the word you, using the word "we" is less aggressive. The word you is singular and stands vulnerably alone. The word we is plural and is interpreted as a sort of togetherness, and has more power.
Instead of using the word should, the word "need" is also less aggressive.
For example, in confronting (guiding) a Patient who is manifesting inappropriate behavior, we could say something like, "Doing so and so is inappropriate, and we want to be appropriate, so we need to do so and so".
While guiding the Patient toward more appropriate behavior, subtle, visual clues are important. For example, while stating "we want to be appropriate", we nod our heads. This action is positively interpreted as a "yes", and the receiver is more drawn to what we are saying.
Tried and true techniques.