Challenge
Cases involving high stress and anxiety alongside panic attacks are some of the more difficult to triage. These cases require not only assessment of physical symptoms, but also a genuine empathy and awareness of the mental situation at hand.
In one such case, *Janine, a high school principal, went through an increasingly stressful event after suspending a student who talked about committing possible violence, temporarily limiting their ability to be on campus. While working, Janine suddenly saw the student in school and had to confront them about staying off campus during their suspension. During the confrontation, the student became increasingly verbally aggressive and as the situation escalated, they began to threaten her and the school with physical violence.
Six days after this, Janine called the Careworks nurse triage line, where she spoke with *Felicity. Janine reported severe anxiety, frequent nightmares, thoughts of self-harm, a constant tightness in her chest, and concern for her own safety, as well as the safety of the students and other faculty.
Solution
After hearing the pure fear and concern in Janine’s voice as well as the vivid description of her symptoms, Felicity first aided Janine in calming down and let her know that she was there to help. Due to Janine’s thoughts of harm and her physical symptoms, such as the tightness in her chest, Felicity recognized this as an emergent situation. She believed it necessary that Janine receive an acute assessment by an emergency room physician who could provide appropriate intervention if indicated.
Felicity assured Janine that there were people, including herself, who would be there for her and that she was in a safe environment. Felicity then continued to take the time to fully assess, support, and comfort Janine throughout the remainder of the triage process.
Result
Shortly after, Janine was diagnosed with adjustment disorder. After her diagnosis, she was able to safely and promptly receive the care that she needed. She was also taught stress-relief techniques and given guidance on what she should do if a similar situation, in or out of work, were ever to arise again. After going through the proper steps, Janine was able to return to work confidently and happily with no restrictions five months later.
*Names changed for privacy purposes