Discussions with a BLS student... February 2013

I wanted to share a ‘conversation’ I had via email this week. As many of you know, I teach BLS (basic life support) in my spare time and one of the benefits I offer my students is that they can contact me by email or phone to ask questions and voice concerns over the time frame that their card is current…so for some students that gives them two years. It doesn’t cost them any more money- it’s just one of the perks that I offer with the class. To be blunt, I rarely hear back from students. Many people take the class for work and are not too stressed as long as they are certified and many just kind of forget as they leave class and go back to their daily business. Every few months, someone will send a letter praising my skills to the hospital and I have also gotten almost universally good evaluations. (I get a ‘bad’ one every few years from one of the local public school English teachers. I was really upset the first time when the evaluation said I was ‘tangentially morbid’, but as he keeps putting it, I have learned to shrug and move on and even laugh about it. The first time he wrote it, I had to look the word up as I had no idea what it meant…which I suspect was also part of his comment. :) However, two weeks ago, I taught a CPR/First Aid class and within three days of the class, my student not only had to use some of the skills I tried to impress on him during the class, but he voiced some really legitimate concerns that I think many of us have in challenging situations. So I thought I would post the ‘conversation.’ I sometimes find trying to address some of my student’s legitimate concerns difficult because I do not feel like I am really a good writer or have an excellent grasp of how to use language to convey feelings and emotions very well. I hope that I did all right…

February 16th, 2013

Hi Sonia,
Your letter confirming training arrived. This afternoon my neighbor called, his wife had fallen, she could not get up and he could not pick her up. He asked if I could come over and help. I've known them for many years, they are both in their late 80's. I went right over. She was on the kitchen floor, her eyes were clear and focused, she said that she did not hurt anyplace only that she did not have the strength to get up. She'd had a brain tumor a couple of years ago and her balance has not been good since, he'd had a heart attack and is no condition to lift more than 5 lbs. I talked with her a while to assess the situation, she seemed to be herself, absolutely clear and lucid. Brought a chair over so that she could steady herself as I picked her up and would not have to move her too far. When she rolled up onto her knees to move I could see the other side of her face there was a large ugly purple spot the size of your palm. She said that she had been to the dermatologist earlier this week and that he had removed a spot, it had not just happened. I put my arms under hers, used my legs to pick her up and she sat down quite easily in the chair.It was tea time, a chance to talk and see how they are doing. The other night she had fallen out of bed and could not get up, they called 911, the ambulance service helped her get back into bed. What they should do is get into an assisted living center - soon, for now they are so entrenched in their home they do not want to go through moving. Getting old is hard. Thank you for the training and the letter,


February 17th , 2013

Wow! That was very quick..... I had a dead phone yesterday so I needed to wait until today but it sounds like you were very helpful and you did the right thing. It doesn't sound like I would have recommended anything different and that was really great of you to help! Did you have any concerns? Did you feel basically prepared and only a little nervous? Is there anything else you wish for me to cover with you....? Anyway, good job and I loved hearing about that!

Sonia G

February 19th, 2013

Hi Sonia,
"Did you have any concerns?" – YES!
Should I being doing this? What If? and still have concerns. The rest of that day and the next day it was still was very much on my mind. More than just this incident - their ability to take care of themselves and that further incidents could cause them pain & suffering. In class the other night you were crystal clear that confidentiality and respect to privacy is paramount. The day after helping them I met a mutual friend and close neighbor in town. I questioned myself as to whether I should say anything or not, I did tell this neighbor about what had happened. It concerns me that I did right or wrong informing this individual about what had happened. As a neighborhood group we have all been very close over the years and helped to take care and watch out for each other through illness and death. Thank you,


February 21st , 2013

So let's chat about that. You are correct- confidentiality and privacy are very, very important. However, there is a loophole in that idea that I didn't really stress so let's go over it. The reason that privacy and confidentiality is so important is that we want people to trust us to give us the information we need to help. However, that information must be given away to others in certain cases. If the patient may cause harm to others, then absolutely we must share the information. If someone is threatening harm to themselves then we must also share that information. We must share it for a few simple reasons, but I think the most important reason is that we cannot allow harm to happen to ourselves... otherwise we become useless to help others. If we keep a secret that later causes us to feel guilt, shame and fear... that causes us to not want to help others anymore... that very much causes harm to ourselves and isn't ok either. So there are legitimate reasons for breaking confidentiality. The situation that you are describing appears to be one of them. If the young lady is likely to continue to fall and to be more likely to get hurt, it is important (if possible) to try with their help to make a plan or come up with ideas to try and develop ways to make the falling less likely. For instance, questioning what the patient feels has caused the last few falls will help a lot. (Does she get dizzy when standing up from sitting, house full of trip hazards, anything situational that consistently puts her at risk?). What then can potentially be changed to help the patient be less likely to fall… You mentioned that her husband can't pick her up if she falls because of his back... Any other family or close friends nearby? One thing that some families and communities have done is to create an informal group for older people in need (this situation is a perfect reason for one). So a small group of like minded, motivated people could talk together and create a plan for helping this family to stay in their home... It sounds like they have no wish to go into assisted living from what you said... So the people in the group would all know each other and have easy contact information for each other. Each person would 'agree' to take a bit of responsibility over the family for a certain amount of time (morning, day, etc...). So they would be available to check on them, visit and help if needed. Once a week or so the group meets either in person or by phone for a few minutes to chat about each person's experiences that week, concerns and any good changes that need to be made- it is awesome if the meetings include the people who need the help. It helps for them to be able to give input on what's working, what's not and what they think they need. Also, a group can share lots of confidential things and when they stay in the group, it’s all good. Does that make sense? Helping your community, the people in it and feeling confident and able to do so is truly the goal... at least for me. I really appreciate your writing and sharing your concerns with me and I hope you will feel more comfortable over time.

To your question of should I be doing this...? Well, that is really up to you. We all have strengths and weaknesses and things that are easy or difficult for each of us. I do not know you very well, but I think I know a few things from our brief time. You are responsible and motivated (you decided you wanted the class, signed up, and even with rescheduling showed up for it. You came with payment, paid attention and asked questions.). You know yourself pretty well (you admitted even when asked a few times that you really probably would never use the book. You felt comfortable being honest about it and didn't feel any concern or need to fib so that I would give you a book and you would toss it later. ). The fact that you feel concerned about these friends/neighbors, etc. suggests you have empathy towards others and concern for their well being and are willing to give of yourself. Some people perform first aid because it makes them feel good about themselves- because they can tell others how wonderful they are and what wonderful things they have done. Your concerns do not appear to be about yourself. You seem concerned with making sure you do the right things and really helping. So it is my thought that you should keep doing this if you feel comfortable enough to try. The more you do it, the more experience will help teach you important things. And over time, many things in your assessment of situations and people will become so easy and just a part of what you do that you will be able to spend more time giving and helping instead of worrying about whether you are remembering everything, etc... Those are just my thoughts though. Please do not think that I am telling you what you must do, etc... I hope I helped answer that question.

What else can I help with? Did this help at all?

Sonia G

February 23rd, 2013

Hi Sonia,
Thank you very much for your thoughtful response to my concerns. It is truly helpful to be able to communicate and receive feedback from someone who understands the causes and roots of concerns such as I had.

Just got off the phone talking with the neighbor who we're concerned about, today they're doing fine. Tomorrow, will go to see them and perhaps have a cup of tea. Over the next few days will talk with a couple of the other neighbors and see if we can come up with a schedule

The days are getting longer ~ Happy photosynthesis!


I really love knowing that everyone in a while, I have a student who has really listened and not just with their head…but with their heart and soul too. They have heard things that I wasn’t even sure that I managed to get out…how do you teach people to have empathy towards others if they do not already have it? I won’t pretend that is a skill I have. Whenever I prepare for a class, I always ask for the spirit to be with me while I am teaching so that the important parts of my message can be discerned and not lost in my 'hyper-whirlwind' that I call me. I am so grateful for these skills and I am so glad that they can help others and give me satisfaction and joy too! Can’t wait for my next class!

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