Why You Shouldn’t Triage Your Date

“Welcome to the Emergency Department. What brings you in tonight?”

“I’m having chest pain.”

(I now initiate eye contact and pay more attention)

“Okay. [typing noises] When did it start?”

“Five days ago.”

(less concerned now)

“Does it hurt more when you breathe or cough?”

“Yea. It hurts the worst when I cough.”

Bingo. You can wait.

I motion the patient to sit at a nearby chair and continue with the next person in line. The whole purpose of triaging is to decide who needs to go back to a room immediately and who can acquaint themselves with the waiting room. Survival of the fittest applies to many situations in life, but the ER is not one of them. If you’re the most fit you will wait longer.

The word “triage” came to us from France. It means “to separate out.” This is a wise idea to implement in the healthcare setting, right? Large volumes of patients requires a steadfast system to organize such chaos. As a triage nurse gains experiences, he/she learns to ask specific questions and listen for key words.

By working as a pediatric emergency nurse I have learned quite a bit about triaging children, and it’s actually remarkably different from triaging adults. For example, a fever of 103 F and a fast heart rate in a happy, pink-cheeked 9 month old isn’t really concerning to me. However, adults don’t have fevers as often and they’re generally less healthy than children, so my ears would perk up and ask for more details of an adult patient with the same symptoms.

There are multiple factors that contribute to a child’s triage, but there are three that I have learned are most important. First, how does the child appear? Is he acting normally for his developmental age? Is he sleeping? Screaming? When provoked, does the child react? Next, I look at the breathing pattern. Is this toddler breathing really quickly or irregularly? Do I see any ribs or abdominal muscle use? Nasal flaring? Lastly, I check the circulation to skin. Is the capillary refill on her fingernails < 2 seconds? Are her lips and skin pink? Dry? Flushed?

All of this happens with a glance, a lift of the shirt, and a tap to the nailbed. Within seconds a nurse can categorize a child as “sick” or “not sick.” (“not sick” indicates that they can wait, not necessarily that they’re totally healthy–although sometimes they are, and the parents are just nervous). In addition to “sick or “not sick” the nurse assigns an acuity (basically, a number 1 through 5) that communicates how delicate the patient’s condition is. I won’t bore you by explaining each number but the point is that a “priority 1” means someone is actively dying and needs intervention immediately, whereas a “priority 5” means that no resources will be used during this patient’s stay and he/she is completely stable–usually if they’re only being seen for a prescription refill or suture removal. (Yes, people come to the Emergency Department for these reasons.)

Unfortunately, my triage mindset has leaked out into my personal life, and I now do this with men.

Yup, it’s true: I triage my dates.

I didn’t try to, and I didn’t realize I was doing this until recently. The fact is that I just like to know my disposition towards a guy I’m dating. Basically, instead of sick/not sick I want to know like/dislike. There’s no in between. Obviously, I don’t use the same assessment criteria, although there have been times when I’ve wanted to lift up a shirt to “check breathing.” (Kidding…kind of? Can you blame me?)

So what assessment criteria do I use to triage my dates? I’m glad you asked. Again, three come to mind. First, I want to know about his faith. Does he have a personal relationship with Jesus? Is he actively pursuing his faith? Does he seek to be challenged? Second, I want to discover his sense of humor, and I really want to know if he thinks I’m funny. This is crucial. I think I’m hilarious…I want him to think so, too. Does he appreciate sarcasm? Puns? Can he be goofy? The last category is travel, and it’s just as important as humor. Does he care about the world? Does he think that all the adventure lies in a suburban house (boring) or in a hostel in Brazil? Does he respect people who are different and believe there’s something to be learned from them?

As you can see, my triage process for men is way more involved than it is for my patients. I know it’s not fair and I shouldn’t do it. Here’s the big difference: ER triage is based on appearance, while my personal triage is based on qualities and attributes–information you can’t gather sitting across from someone at a nice dinner, especially if it’s the first time you’ve met! Obviously, these things take time, but I put pressure on myself to assign an acuity to each man I date. I don’t want to waste time or end up feeling apathetic about someone while I wait for interest to accrue.

*Sigh*

Do you see my challenge? Maybe I need to leave the ER so I’m not constantly triaging the people around me. Who knows, maybe that priority 5 will suddenly become a priority 1 in the midst of my assessment.

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1917 meets 2014

Today I spent time with an old soul. Like, really old.

This all began with an epiphany I had last March. One afternoon I realized that I had spent years telling family and friends of my plans to move abroad and serve the poor, but I wasn’t doing anything at the time to prepare for such a lifestyle of service. In my mind “the widow and the orphan” referred to those living in developing countries, and I would take care of them as soon as I could get my behind to el campo de Nicaragua. Within moments of this awareness I had reset my priorities with a new vow to live with more regard for the widows in my community, particularly the widows on the branches of my own family tree.

My paternal grandma has one living sister, Opal (timeless name, right?). She was married to my great Uncle Roy for many years but he died a few summers ago. When I was growing up Aunt Opal and Uncle Roy frequently came to our family gatherings because they did not have any children of their own. I never really developed a close relationship with her until this past spring.

Here’s the thing: Aunt Opal is really old. So is my grandma. They’re both in their 90s. Aunt Opal’s age has always been a mystery because she refuses to tell anyone her birthday. I recall a time when I was in middle school and I robbed her of her well kept secret. She had asked me to fetch something from her purse, so I pretended I couldn’t find the object for an extra minute while I stealthily opened her wallet and stole a glance at her birthday. I was proud of myself for cracking the code and gaining knowledge of the forbidden. Perhaps that was what Adam and Eve felt like when they tasted the fruit of the forbidden tree…but on a much smaller scale. Much, much smaller. Okay, probably not even a real comparison. Still, the fruit of success had tasted so good to this sneaky middle schooler. Anyway, I’d long since forgotten Aunt Opal’s birth date, but all it took was time spent with her to remind me of just how old she actually is…

If you know me at all, you know that I am a fast-paced person. That’s partly why I love working in the Emergency Department. I love STAT orders and multi-tasking and all things rushed. Hanging out with my 90-something year old aunt has forced me to develop a patient side. Patience is not a quality one can accrue overnight. Or through multiple visits. WOOF.

Today I called up Aunt Opal and asked her to accompany me to ArtPrize. The quaint little city of Grand Rapids, Michigan, in which I reside sports hundreds of pieces of artwork every autumn. After two and a half weeks of crowds, cuss words, and colors, the public selects one winner to receive a prize of $250,000. I wanted to drive Aunt Opal around the city so she could see some outdoor art. No problem.

I parked at her house at half past 4. She slowly made her way to my car via her walker, even though I wouldn’t consider her actual method of transportation “walking.” Step, plant. Step, plant. Pause. Step, plant. Step, plant. She was so dorky and cute, modeling wide-rimmed 1980s glasses, topped with even larger sunglasses that attach to said 80s glasses via a small contraption. I buckled her in and off we went.

My first few verbal exchanges with her are always a rude awakening, and today was no different. She does this thing where if she asks me to repeat myself and she still doesn’t understand me the second time, she just changes the subject and pretends like the miscommunication never happened:

“You, uh…had a party for…Jaime last night? What was it…what was it like?”

“Yup! A bachelorette party.”

“Oh…..a, a what?”

[clear annunciation] “A bachelorette party. “

Pause.

“Your dad said…you have friends visiting from…where was it. Hmm. Poland?”

Our first few conversations are always quick reminders that I need to slow down in conversation. I knew my obsession with haste would also be a problem during our drive-by art viewing. I was careful to give her a good heads up, usually at least one block, so that she would already be looking leftward when we’d pass an urban display. I tried it out:

“Up on your left we’ll pass a giraffe. It’s in the grass outside the church!”

[approaching art]

“What?”

[getting closer]

“On the left, right there! (pointing frantically) Do you see it?!?”

[passing art]

“Oh…I must’ve missed it. (chuckles) Hun, I promise I’m trying!”

I wrapped around the block again and repeated the process. She missed it again. Sigh. I couldn’t even be frustrated–those glasses were just too cute. Besides, the clouds were amazing today. Aunt Opal and I both love clouds, and today the sun broke through the gray sky blanket several times. Thankfully, ooh-ing and aah-ing doesn’t require unhurried diction.

We browsed the art scattered around the downtown museums before we changed routes and headed home, our communication improving with every chat. Except that I was trying to drive safely and talk slowly, which required momentous effort on my part. Several cars caught my eye as they passed me. What? Cars don’t pass me. I pass cars. I glanced at the speedometer. Almost 10 mph under the speed limit. I couldn’t believe it! I was starting to slow down in more ways than one. Seven months of intermittent hang outs, flower patterned letters, and phone calls, and Aunt Opal is finally starting to rub off on me. I couldn’t be happier. I need deceleration in my lifestyle and it does not come naturally or easily.

I was so happy and hopeful that without thinking, I boldly asked, “Aunt Opal, when were you born?” A pause and a chuckle later, and I got what I was looking for. “Well, Kay, I won’t say it in full, but I will tell you this: 17.”

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the writer who hates writing

“I hate writing.” 

I can’t tell you how many times I’ve made this claim throughout my life. Here’s the truth: that’s a lie. 

I actually love to write. I’ve kept a journal since I was 11 years old. In fact, I can’t not have a journal. I have bought notebooks specifically for trips, vacations, and seasons. So why have I always said that I hate writing?

I think I hate being forced to write. Newsflash, self: you hate being forced to do anything

Former English class writing assignments that required a formal paper always invited a headache. I spent long hours uncomfortably seated at the family computer in our living room, groaning internally and externally (yup, you guessed it–I’d say, “I hate writing!”) and drowning in mental complaints. I’d finish the paper at 2 am and head upstairs but found that I couldn’t fall asleep until I penned thoughts into my journal. 

Oh, the irony. 

I’ve tossed around the idea of creating my own blog for several years but the pressure of being forced to write prevented me from taking initiative. So to begin, I am setting an incredibly important expectation in my very first post: nobody around here is being forced to do anything!

 

Bon voyage!