Last week I dealt with a member in the Chat Room. She told me she was having a pain crisis and needed help urgently.
I advised her to drop everything and get to an Emergency Room. She told me she was all alone, (in England) and had no family, friends or neighbors who could drive her to the ER.
I ultimately spent over two hours throwing out suggestions, which she continually rejected. The only suggestion she agreed to try was a hot wet cloth on her cheek, which she said helped.
It took me quite a while to recover from my own pain crisis from sitting at the computer for so long and the stress from her making me believe that I was her only lifeline.
I have since discovered she's Bi-Polar and my best guess was that I was sucked into her Manic Episode. I've also since learned she has a boyfriend? Where was he?
My satisfaction at being a positive force for good has been replaced by a resolve to NEVER sign in to the Chat Room again! I felt that I'd been hijacked by someone who was off their meds and expected me to rescue them.
Without being judgemental about Bi-Polar members or members with chronic mental health issues, I think it would be beneficial to the moderators to know who they are as soon as they can be identified.
Can we learn enough by reviewing the patient's personal profile, to know when we need to disengage? Even if we know, this is certainly a touchy one. Setting limits can be tough at a distance, even if we had the training to recognize patterns where we must do that.
The "yes, but" game isn't unique to bi-polar personalities. One can see it a lot in people with lesser debilities that were once called "neurotic". And it's infamous in people with borderline personality disorder. In the latter category, a very stark insight is provided by a book title: "I hate you, please don't go."
No, we can't learn enough by reviewing a member's profile information.
Of three members who have told me they're Bi-Polar, none of them mentioned it in their profile information. But then, why would they? It's private medical information and not something that should be available for anyone to read.
I think this could be dangerous because then people could vent about people and then it could get copy and pasted.
Gloria - spending two hours with someone is above and beyond the call of duty. You have to let them be sometimes. You have to focus on your own health too. You're a trooper but I'm worried that you'll put them before you put yourself. :)
In the past, I was a member of a volunteer hot-line that provided military members with information of the precise rules and regulations regarding military discharges ,e.g. conscientious objectors, family hardships, medical and psychological issues ,sexual orientation etc. Gathering vital information about their circumstance required enormous patience. It was not uncommon when after lengthy conversation, an important piece of information was added that changed the entire strategy of proper guidance. Every volunteer on the hotline experienced this and it drove everyone crazy. Troubled people are reluctant to share extremely important background information. We accepted this. I became a better interviewer.
Call upon the Gods of Patience to prevent frustration. You are doing good work.
Thank you for starting the conversation. We will all learn from this. TN folks can be a pain in the facial cheek in addition to the cheek we sit on.
Gloria, this was a difficult situation and I regret I was unable to help with it. Maybe here in the Mods group we could have a very PRIVATE list with members who "take more of our time than others"!!! It could be started as a discussion that members can add to as the problem arises, just so we can all be alerted. I often tick the green dot so no one knows I am on site,and I feel a swine for doing it. I would say start every conversation with " I have a Dr's appt. shortly sorry must be quick!" 2 hours is 1.8 hrs too long to spend out of your life, it's a Chat Room, not a therapy session! If we spend too long in there with one person they may think it is a "right" they have, it just cannot be.
Thank you Red, Scott, Bill and Jackie, for your kind words and support.
This is the first real brush I've had with Compassion Fatigue I've had, although it was a valuable learning experience.
Yes, Jackie, I now make sure I'm off-line in the Chat Room. You shouldn't feel like a swine about it. Sheer self preservation.
Scott, I felt the same concern about the member's privacy, which is why I thought I'd throw it out there and get other's opinions. Like Jackie, I was hoping we could have a very PRIVATE list somewhere that could be added to, ((( I like Jackie's suggestion "Members who take more of our time than others" - very displomatic ))) to share this information with each other, but you think it's too potentially dangerous? We should keep any discussion about difficult members off-site in private regular email?...or simply not discuss it at all???
we could have an email sent out explaining the euphanism to mods private email explaining that the real meaning of MEMBERS TO LOOK OUT FOR WHO NEED OUR HELP THE MOST ? Unless we all understand though it could give the wrong signal. I have similar worries to Scott and even a private email to home addresses can be copy and pasted. Maybe we could ask Rose to put something on members profile pages that we can flag like the rest of the list on the left side?
But I would not like any Mod to be stuck in the chat room for so long again, that's almost criminal. There are agencies here in the UK who could have helped that member. We have NHS direct which gets urgent medical care to people who need it. It can force your GP or DR or out of hours clinic/drop in centre to see you if they consider it urgent enough. Also there is the Samaritans who speak to the lonely or suicidal or any reason at all in a non judgmental way, there were better options available for that member that would not involve tiring you so much. No more, please!
I wonder if all of us who moderate wouldn't profit from a short private session or training document, on Dealing with Difficult Patients? TNA circulated a CD information disk a few years ago that speaks to many of the issues Gloria raises, and offers procedures for people in care giving positions (I've done similar hot line work to that which Bill describes, though in the rather distant past).
I will dig out the disk and see whether any of the material can be copied for discussion in this forum. Alternately, an off-site email list seems reasonable, as a place to name names. Either way can be private and obviously should be...
Here's another contribution to the difficult members thread. Phoebe and Kathy are advocating for some alternative medicine treatments in a thread called "Who else has made a trip to the ER...". Gloria has (rightly in my view) contradicted some of Phoebe's claims. The following is my latest posting to the thread...
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Kathy and Phoebe --
It is not my purpose to get into a public hair-pulling match with either of you on issues of your personal experience of medical therapies. Your individual experience is, after all, your experience. This isn't an issue of who is right or wrong.
The balance I am striving for is to inform other readers that some techniques offered by so-called Complimentary and Alternative practitioners don't appear to have any science (or in some cases even documented data) beneath them. And some are clearly fraudulent. The 100% relief claim for TN is one of the more reliable indicators for fraud. Claims that contradict or confuse what is known of the physiology of the human body should also be looked at skeptically.
That said, we all have a right to pursue the possibilities for improvement. "This worked for me" is -- with rare exceptions for known frauds -- valid. The place where I get off that trolley is when people try to generalize from such a sample of one, to advocate for their chosen solutions with other members. To support advocacy, there needs to be valid data in larger samples, and a record of published results subject to professional peer review and evidential oversight. "This worked for me and it will work for you" isn't good enough (and please understand that I'm not accusing anybody of having phrased their opinion in exactly this way).
In all of this, I understand and accept that I don't set policy for Living with TN. Only the owners do that, sometimes consulting with the moderators, of whom I am one of several. Mine is not the only voice here and I would never wish it to be. The value of a forum like this one is very often the support and information that members bring here for each other. When I can lend the insights of 45 years of experience in scientific analysis, and 16 years of advocating for better patient outcomes, I will try to do that -- with courtesy. Sometimes I will write with passion, for I've seen people hurt badly by their own wishful thinking and the manipulations of financial predators wearing white lab coats and preaching snake oil and nonsense. I hope I shall be pardoned for that passion when it may contradict the passionate concerns of others. Finding truth and healing isn't about me or you.
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If other moderators care to weigh in with their own views in that thread, I'd welcome the company -- either in support or in reasoned contradiction. As I wrote to Phoebe and Kathy, it isn't about me.
Red, I put a note on and my intention was to diffuse and soften the situation. It must be very frustrating for you and Gloria but I thought I would do "good cop" to save the mods having a bad rep. Hope it is OK for you?
In all candor, both Gloria and I are thinking about suspending Kathy for 30 days. She seems to be advocating for a therapy that isn't supported by medical evidence, and she pushes back hard when that's pointed out to her. The other side of this coin is of course the "don't be a treatment nazi" thing. That's why I'm interested in hearing the views of other Moderators, including yours, of course.
"Dealing with Difficult Patients" is a great idea. I'm a hospice volunteer (near Duboce, Triangle Red). Dealing with difficult patients is an important part of the volunteer training program. Looking forward to seeing it, Red
I've newer walked into the "Chat Room". Maybe it's time.
I've gone through the DVD materials provided by TNA a few years ago to their telephone support volunteers. The material comprises a two-hour series of lectures to a group of telephone support volunteers in TNA's support group system. The principles seem pertinent to support people who deal real-time by phone with patients who are in crisis. I'm not so sure it works well for a chat room environment, where patients don't hear voice tone and where the speed of communication is slowed by keyboarding when one's coordination may be compromised.
In a chat room, there is an arms-length, non-real-time dimension of the experience. TNA volunteers also regularly deal with people who are suicidal. While we may encounter people in our chat room who are struggling with similar feelings, none of us are counselors and we don't want to expose the site to legal liability issues. So there are serious dissimilarities in the process as well as similarities.
My instinct at this point is that as a first step, all of us as Moderators may want to read and talk about Section 4 of our menu page on Coping With Crisis. The material deals with "When You Just Can't Take It Any More". And it focuses on getting people in crisis to go to nearby family members, local emergency rooms or clinics and crisis-intervention centers. The most important principle I can think of to organize our help around is "talk to somebody nearby... don't allow yourself to get trapped in depressed isolation." A second and also important organizing principle is that we can't actually "help" people in crisis or give them solutions. They have to help themselves and own the healing process for themselves, taking back the power they have relinquished as they entered the crisis in the first place.
I invite the comments of others on these general ideas.
Sorry Red" I am on the iPad and have not seen any messages as not set up for emails. It has a conversational feel to me of someone edging for a scrap. When this stage is reached someone has to give or problems arise in the members rank. I have seen her take this spat to another discussion. It may now escalate. It is a massive worry when members advocate an unsuitable treatment. I really think you will have to act if there is further remark along this thread.
Richard A. "Red" Lawhern said:
Jackie,
In all candor, both Gloria and I are thinking about suspending Kathy for 30 days. She seems to be advocating for a therapy that isn't supported by medical evidence, and she pushes back hard when that's pointed out to her. The other side of this coin is of course the "don't be a treatment nazi" thing. That's why I'm interested in hearing the views of other Moderators, including yours, of course.
Red as you know I am very au fait with section 4, so it makes it a bit easier for me. Somehow we have to get the message across that while being caring of members we do not have all the answers and cannot perform any miracles. One suggestion is to keep out of the chat room and keep the red dot on when on site so we can be here discretly. some members are very needy and their behaviour can be the hardest to understand. I had up to 12 messages a day from one member for about 4 days. I answered each one with patience asking her to talk to her Dr and refer to the Face Pain Info tab. Still more q’s came back. Then nothing! Then I noticed she had left the group, then this week she has rejoined. Go figure, I can’t.
Richard A. “Red” Lawhern said:
Bill and others:
I’ve gone through the DVD materials provided by TNA a few years ago to their telephone support volunteers. The material comprises a two-hour series of lectures to a group of telephone support volunteers in TNA’s support group system. The principles seem pertinent to support people who deal real-time by phone with patients who are in crisis. I’m not so sure it works well for a chat room environment, where patients don’t hear voice tone and where the speed of communication is slowed by keyboarding when one’s coordination may be compromised.
In a chat room, there is an arms-length, non-real-time dimension of the experience. TNA volunteers also regularly deal with people who are suicidal. While we may encounter people in our chat room who are struggling with similar feelings, none of us are counselors and we don’t want to expose the site to legal liability issues. So there are serious dissimilarities in the process as well as similarities.
My instinct at this point is that as a first step, all of us as Moderators may want to read and talk about Section 4 of our menu page on Coping With Crisis. The material deals with “When You Just Can’t Take It Any More”. And it focuses on getting people in crisis to go to nearby family members, local emergency rooms or clinics and crisis-intervention centers. The most important principle I can think of to organize our help around is “talk to somebody nearby… don’t allow yourself to get trapped in depressed isolation.” A second and also important organizing principle is that we can’t actually “help” people in crisis or give them solutions. They have to help themselves and own the healing process for themselves, taking back the power they have relinquished as they entered the crisis in the first place.
I invite the comments of others on these general ideas.
Online support is online support, and who knows "what" is on the other keyboard.
My instinct at this point is to move the cursor to the little "X".
It's a scary thought, Red, you going over Kathy's link with a "fine tooth comb" and "hair-pulling" - Yes, it's just me with a "Rogaine testimonial" joke;) bob
Online support is online support, and who knows "what" is on the other keyboard.
My instinct at this point is to move the cursor to the little "X".
It's a scary thought, Red, you going over Kathy's link with a "fine tooth comb" and "hair-pulling" - Yes, it's just me with a "Rogaine testimonial" joke;) bob