Tag Archives: psychiatric emergency room

Are you willing? Are you ready?

By Nancy S Buck, PhD, RN

During one of my regular shifts in the psychiatric emergency room of a general hospital a patient arrived who was feeling exceedingly anxious and worried. He had experienced a number of recent life events contributing to his emotional state. And he added to his list of recent concerns by piling on more issues and challenges he had been juggling and trying to handle for awhile.

In my well meaningman2 attempts to be helpful I shared some very specific ideas and suggestions for some coping skills he could immediately start to implement. Simply taking some deep breaths and focusing on the rise and fall of his chest and belly should be a good and helpful start. These suggestions were met with an increase in his upset and anxiety leading to tears. Clearly I was contributing to his condition worsening.

Later it hit me. This fellow was invested in his upset and suffering. He was not yet read or willing to change.

I was reminded of my own personal experience years earlier. While washing dishes I was deep into an argument with my husband, even though my husband was not home at the time.

At some point I realized my ranting, raving and complaining was not helping me get what I wanted and needed. I even went so far as deciding a different course of action that would help me get what I wanted and needed.

I asked myself two important questions:

Am I willing to do something different?

          Am I ready to do something different? 

          NO!

This was the simple truth. Even though I had evaluated my present behavior as being ineffective, I was not ready or willing to give it up . . . YET!

The present argument was quite satisfying. I was able to express my feelings and desires without interruption. I could be right and righteous without interruption or contradiction. I would WIN this argument.

Later, I told myself, I would approach my husband and engage in a conversation where we could work toward compromise and mutually satisfactory solutions. Later I would be ready and willing.

Now I know better. Now I will still offer my patients some immediate skills and solutions to help them improve their sense of well being and settle their emotional upheaval. But first I will ask:

Is what you are doing now helping you get what you need and want?

Are you willing and ready to consider doing something different?

Respecting their present state of mind I will ask if they are ready, willing and wanting to move forward for greater Mental Health and Happiness.