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Syntax Training | Lynn Gaertner-Johnston

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January 23, 2012

Comments

kathy

I've found this definition of triage:

"The process of sorting people based on their need for immediate medical treatment as compared to their chance of benefiting from such care."
So I can understand that triaging an issue list means giving some priorities to the items and sorting the list.

But what does triaging an issue mean? Giving it a low priority or the other way round? I suppose the former but haven't found any evidence for it. All the dictionaries I've found deal with triaging some set only.

Randy Averill

I think a reasonable response from the patient (or family member) would be, "I want to make sure I answer correctly, so please help me understand what 'triage' looks and feels like in this office. We've been greeted, but I'm not sure how to know if I've been triaged."

It's tempting to express frustation at having been expected to know the medical jargon and, therefore, to respond with some measure of frustration. However, maintaining composure and responding as I've suggested will typically get the point across to the staff member and bring them instantly into a helpful mode.

As the bystander, I would suggest approaching the staff member privately (e.g., as they're walking away from the patient) and pointing out that, if you were asked the same question you might not know how to respond. A gentle nudge reminding them that "inside baseball" talk can lead to tremendous misunderstandings should be sufficient.

Cathy Miller

I'm afraid my Shoulder Satan would have gotten the better of me (even though I know the term).

I probably would have responded with, "No, I thought it was better if the doctor did that." :-)

After spending 30+ years in the healthcare industry, I know how easy it is to fall into acronyms and industry jargon. Randy's approach is a much better one than mine. :-)

Lynn Gaertner-Johnston

Hi, Kathy, Randy, and Cathy. Thanks for your engaging responses. I appreciate your points of view.

I think an important factor is the reason people are in a doctor's office. I was there because my father had experienced intermittent shortness of breath, leg swelling, and congestion. So I was not focused on giving a gracious response like Randy's! However, I admire it.

Lynn

LesterSmith

When M*A*S*H was on the air, the word was commonly understood, and I believe it found use even in business settings at the time. Interesting that it hasn't remained with us. I suppose that says something of how faddish even business jargon can be from decade to decade.

Lynn Gaertner-Johnston

Hi, Lester. Thanks for mentioning M*A*S*H. I enjoyed it, but the word "triage" did not stick with me from it.

Even if we understand the word, "triage" does not seem appropriate for use with patients. I don't think we would say, "Have you been sorted and prioritized yet?"

If you see this comment, please let me know if you agree.

Lynn

LesterSmith

Hi, Lynn.

I definitely agree with you. The word "triage" is medical jargon. Worse, even if understood, it seems mechanical, not at all good "bedside manner." (I wouldn't have used it even with soldiers during my old days as a National Guard medic.) I suppose the lesson of all this is that good communication should focus on audience need; it isn't just an information dump.

Cheers,

Les

Terry Murphy

I have a couple of comments to add here, Lynn.

Firstly, although I'm not a fan of television medical 'dramas', I've seen enough snippets here and there to be very surprised that anyone these days isn't familiar with triage as a word or a concept. This is not a criticism of anyone who isn't familiar with the word. I'm just very surprised.

The second point relates to the original communication. I assume it was a verbal communication, most likely even face-to-face. In that circumstance — face-to-face — the 'sender' has plenty of (non-verbal) feedback to decide whether the 'receiver' has actually understood or is unsure. The sender can instantly provide further clarification or explanation if required.

In the context of your blog, that instant feedback isn't available to the writer of a written communication, so use of jargon is much more problematic.

In answer to your question, if asked if I had been blahed, my responsed would be, "I'm sorry, but I have no idea. What is blah?"

Thanks for raising these issues. It's good to be prompted to think about them.

Cheers

Terry

Lynn Gaertner-Johnston

Hi, Les. Thanks for responding and revealing something about your life. As a National Guard medic, you must have especially liked M*A*S*H.

And thanks for elaborating on the ill-fitting "triage."

Lynn

Lynn Gaertner-Johnston

Hi, Terry. Thanks for stopping by and chewing over this subject.

I agree that many people understand "triage." My father and the other elderly man in the waiting room are not among them.

If I myself had been asked the question, I believe I would have replied, "What exactly do you mean?" Sitting in a medical waiting room, especially with a worrisome health problem, can cause a person to lose confidence about lots of things, including the meaning of words.

I like your point about non-verbal feedback. We can hope that a clinic employee would recognize confusion about the term "triage" and find another way to phrase the question.

Thanks for your thoughts.

Lynn

Marcia Yudkin

Terry,

In my studies of business communication, I've found an epidemic of people assuming wrongly that their audience understands a certain word or phrase. And Lynn's case starkly shows the consequences of doing so.

Why cause needless bewilderment, embarrassment and miscommunication in a situation where customers are already ill at ease?

Even in a less emotionally charged setting than a medical clinic, most people don't want to admit that they did not understand something.

Here something simple like "Have we spoken with you yet?" would do a far better job of communicating the message while being kinder to those who do not watch medical dramas on TV - as well as those who do not have English as their first language.

- Marcia Yudkin

Lynn Gaertner-Johnston

Hi, Marcia. Thank you for your eloquent argument against jargon. I am glad you reminded us about people who do not speak English as a first language.

Lynn

Terry Murphy

Oh Marcia, you've made me blush with embarrassment! I've made the error of 'gifting' everyone my context. I should — and DO — know better. Your ESL point is very well made too.

I'm not sure though that your simple message necessarily does a "better" job. Someone may have actually spoken with the man, but that might be a long way short of him being properly triaged. It's all about context, isn't it. The staff member's understanding of "spoken to" and the patient's understanding of it will be a long way apart.

In the medical centre staff's defence, it would very quickly become a very long shift if they had to enquire of each patient whether they'd "had their vital signs checked and urgency of treatment assessed" and that's just my own inadequate non-medical rendering of what a triage does.

Perhaps there's a point where we use the jargon in F2F conversations, observe closely and clarify where necessary? Writing is a whole different matter as we know.

Interesting discussion.

Lynn Gaertner-Johnston

Hi, Terry. I suggest we ban jargon from the medical waiting room. It simply does not belong there.

I like Marcia's suggestion. I would take it a step further perhaps with "Has a medical staff person spoken with you yet?" or "Has a nurse spoken with you yet?"

So far not one participant in this discussion has said he or she would answer the question "Have you been triaged yet?" with confidence. That fact should change your mind.

No "triage" talk with patients!

Lynn

Andreas Neustifter, Austria

Just on a quick side note: here in Europe, as far as I can tell, the term is only used during medical emergencies where a limited amount of personal has to tender to an overwhelming amount of patients quickly. (Its even used in German to refer to the same concept.)

What I find more interesting is that it is used in the software development community to describe the continuous process of assessing and prioritising bug reports.

Lynn Gaertner-Johnston

Andreas, thank you for giving us the European perspective.

Software development folks use "triage" for bug reports? Very interesting!

Thanks for taking the time to write.

Lynn

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