Crisis, Coping Mechanisms Running Wild


I recently saw a cartoon depicting one of those adorable Minions, with the caption, “Ever have one of those days when you’re holding a bat and everyone looks like a piñata?” This gave me quite a chuckle, but when I stopped to really think about it, I thought about how well this related to people in crisis.

Crisis from a new, scary diagnosis, crisis from a financial situation, abuse, those facing their own mortality, or the mortality of their loved one. Any one of these can make one feel just like that Minion. Or, on the flip-side, sometimes a person may feel like they are a piñata, and they are being hit from all sides.

Through working in healthcare, the types of crisis situations I come across regularly are a scary, new diagnosis, and facing death head-on. Things like this make emotions run all over the place, to put it mildly. Coping mechanisms such as denial, anger, and bargaining can become a tangled mess, and can get in the way of a serious discussion about treatment options, and what the patient really wants. I’ve seen first-hand over the years, how a crisis can bring out the best and worst in people. The best looking something like gravitating towards the crisis—wanting to help, love, and support. The worst looking something like lots of arguing, selfishness, and blame.

What’s been very clear to me over the years, is people need time and space to process bad news—of course, the length of time and space varies from person to person. Some need to ‘sleep on it.’ Others need five minutes, and they are ready to hit the ground running with their decision.

For those whose emotions and coping mechanisms are running wild, one has to be creative in their approach. Let’s face it, not everyone is ‘one size fits all.’ I approach a child with a terminal diagnosis differently than I do someone who is fifty, and differently than someone who is eighty-five. Likewise, I can’t approach someone who is very angry in the same manner I do when someone is in acceptance.

Regardless of the situation, the ‘ole stand-by’ for me is to let the person know you care. That simple task can break down barriers that initially seemed to be covered with barbed wires of anger, and find a path through the denial and bargaining. This one, simple, task can open doors to a beautiful conversation about life, goals, dreams, accomplishments, and what they really want. After all, isn’t it about the patient?

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About Janet Belford

Janet Belford, RN, CLNC, has been a registered nurse for over 24 years, having worked in the pediatric and adult patient populations in critical care, outpatient, case management, and hospice. She is also a Certified Legal Nurse Consultant. She brings to the table a passion about patient rights, informed consent, healthcare integrity, domestic violence, patient and family education, mentoring for fellow nurses, and end-of-life care. It is part of Janet’s mission to ‘be real’ with patients and families, not shy away from ‘difficult conversations,’ and to advocate for patient rights.

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