An ER doctor on triaging your "crazy busy" life | Darria Long

Prevoditelj: Ivan Nekić Recezent: Sanda L

Raise your hand, and be honest,

Podignite ruku i budite iskreni,

if you've used the phrase "crazy busy"

ako ste upotrijebili frazu "ludnica"

to describe your day, your week, your month.

kako biste opisali svoj dan, svoj tjedan, svoj mjesec.

I'm an emergency-room doctor,

Ja sam liječnica hitne pomoći,

and "crazy busy" is a phrase you will never hear me use.

a "ludnica" je izraz koji nećete nikad čuti kako koristim.

And after today,

A nakon ovoga danas,

I hope you'll stop using it, too.

nadam se da ćete i vi to prestati koristiti.

Here's why you cannot afford to use "crazy"

Evo zašto si ne možete priuštiti korištenje "ludnice"

to describe your busy.

za opis svoje opterećenosti.

Because when we are in what I refer to as Crazy Busy Mode,

Jer kad smo u onome što nazivam stanjem ludnice,

we are simply less capable of handling the busy.

jednostavno smo manje sposobni nositi se s opterećenjem.

Here's what happens.

Evo što se događa.

Your stress hormones rise and stay there,

Vaši hormoni stresa rastu i ostaju visoki,

your executive function in the prefrontal cortex declines.

vaša izvršna funkcija u prefrontalnom korteksu opada.

That means your memory, your judgment, your impulse control deteriorate,

Tada se vaše pamćenje, prosuđivanje i kontrola impulsa pogoršavaju,

and the brain areas for anger and anxiety are activated.

a aktiviraju se područja mozga za ljutnju i tjeskobu.

Do you feel that?

Osjećate li to?

Here's the thing.

Evo u čemu je stvar.

You can be as busy as an emergency department

Možete biti opterećeni kao hitna služba

without feeling like you're crazy busy.

bez osjećaja "ludnice".

How?

Kako?

By using the same tactics that we use.

Upotrebom iste taktike koju koristimo.

Our brains all process stress in similar fundamental ways.

Naš mozak obrađuje stres na slične temeljne načine.

But how we react to it

Ali kako reagiramo na to

has been shown by research to be modifiable,

istraživanja su pokazala da to možemo mijenjati,

whether it's emergencies or just daily, day-in, day-out stress.

bilo da je riječ o hitnosti ili samo svakodnevnom, dnevnom stresu.

Now contrast Crazy Busy Mode

Za razliku od osjećaja ludnice,

with how I think of us in the ER -- Ready Mode.

u hitnim službama je potrebno stanje spremnosti.

Ready Mode means whatever comes in through those doors,

Stanje spremnosti znači sve ono što dođe kroz ta vrata,

whether it's a multiple-car pileup,

bilo da se radi o lančanom sudaru,

or a patient having chest pain while stuck in an elevator,

ili pacijentu koji osjeti bol u prsima dok je zaglavljen u liftu,

or another patient with an item stuck where it shouldn't be.

ili drugom pacijentu s predmetom zaglavljenim tamo gdje ne bi trebao biti.

When you're know you're dying to ask.

Kad znaš da umireš od znatiželje.

(Laughter)

(Smijeh)

Even on those days when you would swear you were being punked,

Čak i onih dana kad biste se zakleli da se šale s vama,

we're not afraid of it.

ne bojimo se toga.

Because we know that whatever comes in through those ER double doors,

Jer znamo da se možemo nositi sa svime što dođe

that we can handle it.

kroz ta dvostruka vrata hitne.

That we're ready.

Da smo spremni.

That's Ready Mode.

To je stanje spremnosti.

We've trained for it,

Prošli smo obuku za to,

and you can, too.

a možete i vi.

Here's how.

Evo kako.

Step one to go from Crazy Mode to Ready Mode

Prvi korak za prelazak iz ludnice u stanje spremnosti

is to relentlessly triage.

je neumoljiva trijaža.

In Crazy Mode, you're always busy, always stressed,

U ludnici ste uvijek zauzeti, uvijek pod stresom,

because you're reacting to every challenge with the same response.

jer na svaki izazov reagirate istim odgovorom.

Contrast that with Ready Mode,

Za razliku od stanja spremnosti,

where we triage,

kad provodimo trijažu,

which means we prioritize by degree of urgency.

što znači da dajemo prednost prema stupnju hitnosti.

This isn't just a nice way to get your to-do list done.

Ovo nije samo lijep način da načinite svoj popis obveza.

Work by Dr. Robert Sapolsky

Rad dr. Roberta Sapolskog

shows that individuals who cannot differentiate threat from non-threat

pokazuje da pojedinci koji ne mogu razlikovati prijetnju od ne-prijetnje

and react to everything with the same response

i na sve reagiraju istim odgovorom

have double the level of stress hormones.

imaju dvostruku razinu hormona stresa.

Which is why this is the first skill to learn.

Zbog čega je ovo prva vještina koju smo naučili.

You can't take care of them all at once,

Ne možete se brinuti za sve odjednom,

but you don't have to.

ali ni ne morate.

Because we triage.

Jer provodimo trijažu.

Red -- immediately life-threatening.

Crveno -- neposredna životna opasnost.

Yellow -- serious, but not immediately life-threatening.

Žuto -- ozbiljno, ali ne odmah opasno po život.

Green -- minor.

Zeleno -- manje važno.

And we focus our efforts first on the reds.

I usredotočujemo svoje napore prvo na crveno.

Now hear this.

Sad čujte ovo.

Part of the problem in Crazy Mode

Dio problema u načinu ludnice

is that you are reacting to everything

jest da reagiraš na sve

as if it is red.

kao da je crveno.

So start by triaging correctly.

Dakle, počnite ispravnom trijažom.

Know your reds.

Upoznajte svoje crvene.

They're what is most important and where you can most move the needle.

Oni su ono najvažnije i tu najviše možete pomaknuti kazaljku.

Now it's easy to be confused by noise,

Lako je biti zbunjen bukom,

but what it noisiest is not always what is most red.

ali ono što je najglasnije nije uvijek ono što je najviše crveno.

In fact, my severe asthmatic patient is most at risk when he's quiet.

Zapravo, moj teški astmatični pacijent je najviše u opasnosti kad je tih.

But my patient over here, demanding that I bring her flavored coffee creamer,

Ali moja pacijentica ovdje zahtijeva da joj donesem kavu s aromom,

she's noisy, but she's not red.

ona je bučna, ali nije crvena.

I'll give you an example from my own life.

Dat ću vam primjer iz vlastitog života.

Last spring, my house flooded,

Proljetos mi je kuća poplavila,

my one-year-old was in the ER,

moj jednogodišnjak bio je na hitnoj,

I was supposed to do a fundraiser for my four-year-old's school

trebala sam prikupiti sredstva za školu svoje četverogodišnjakinje,

and the final chapter of my book was beyond late.

a posljednje poglavlje moje knjige je jako kasnilo.

Maybe not ironically, that was the chapter on stress.

Možda nije ironično, to je bilo poglavlje o stresu.

(Laughter)

(Smijeh)

My red tasks were getting my one-year-old better

Moje crveni zadatci bili su zdravlje mog jednogodišnjaka

and finishing my book.

i dovršetak moje knjige.

That was it.

To je bilo to.

Remember, relentlessly triage.

Sjetite se, neumoljiva trijaža.

The house flood repair?

Popravak poplavljene kuće?

Well, once we had stopped and stabilized the damage,

Pa, nakon što smo zaustavili i stabilizirali štetu,

it was no longer a red.

to više nije bilo crveno.

It felt red,

Izgledalo je kao crveno,

but it was in fact just noise.

ali zapravo je to bio samo šum.

No, no really, it was quite noisy,

Ne, zbilja, bilo je jako bučno,

this picture on the far right is me wearing earplugs

na slici sasvim desno ja nosim čepiće za uši

to focus on my book,

da se usredotočim na knjigu,

while the floor is being mechanically dried around me.

dok se pod mehanički suši oko mene.

Know your reds,

Znajte što vam je crveno

and do not let your non-reds distract you from them.

i ne dopustite da vas ne-crveno odvrati od toga.

By the way, it is liberating with a green task

Usput, zelene zadaće su oslobađajuće.

to, every once in a while, be able to remind yourself,

S vremena na vrijeme se možete podsjetiti:

"That's a green task. No one's going to die."

"To je zelena zadaća. Nitko neće umrijeti."

(Laughter)

(Smijeh)

It's OK if it's not perfect.

U redu je ako nije savršeno.

Now there's one last triage level that we use in the worst scenarios.

Postoji i zadnja razina trijaže koju koristimo u najgorim scenarijima.

And that is black.

A to je crno.

Those patients for whom there is nothing we can do.

Oni pacijenti za koje ne možemo učiniti ništa.

Where we must move on.

Gdje moramo krenuti dalje.

And although it is gut-wrenching,

Premda smo rastrgani.

I mention it,

Spominjem to,

because you each have your own equivalent black tasks in your life.

jer svatko od vas ima svoje crne zadaće u životu.

These are items that you must take off your list.

To su teme koje morate maknuti sa svoga popisa.

And I think many of you know what I'm talking about.

I mislim da mnogi od vas znaju o čemu govorim.

For me, this was the fundraiser.

Za mene je to bilo prikupljanje sredstava.

I had to step down.

Morala sam odustati.

Because as we in the ER know,

Jer kao što u Hitnoj znamo,

if you try to do everything,

ako pokušaš obaviti sve,

you have no hope of saving your reds.

nema nade da spasiš svoje crvene.

Step two to go from Crazy Mode into Ready Mode

Drugi korak za prelazak iz ludnice u stanje spremnosti

is to expect and design for crazy.

je očekivati ​​i pripremati se za ludnicu.

Half of handling crazy is how you prepare for it.

Polovica reakcija u "ludnici" ovisi kako se pripremite za nju.

So if step one we triage,

Pa, ako je prvi korak trijaža,

step two, we design to make those tasks easier to do.

drugi korak je priprema da lakše izvršimo te zadatke.

Science shows us that the more options we have,

Znanost nam pokazuje da što više mogućnosti imamo,

then the longer each decision takes.

svaka odluka traje dulje.

And the more decisions we have to make, the more exhausted our brain gets

I što više odluka moramo donijeti, naš mozak je iscrpljeniji

and the less it is capable of making good decisions.

i manje je sposoban donositi dobre odluke.

Which is why this step two

Zbog toga i ovaj drugi korak

is about finding ways to reduce your daily decisions.

govori o pronalaženju načina za smanjenje svakodnevnih odluka.

Here are four easy examples you can use in your daily lifestyle.

Evo četiri jednostavna primjera koja možete koristiti u svakodnevnom životu.

Plan.

Plan.

Plan your entire week's meals on the weekend,

Isplanirajte vikendom obroke za čitav tjedan,

so that when it's Wednesday at 6pm

tako da kad je srijeda u 18h

and everyone's hangry and requesting pizza,

i svi su gladni i traže pizzu,

you have no decisions to make to get a healthy meal on the table.

ne trebate donositi odluke za staviti zdrav obrok na stol.

Automate.

Automatizacija.

Never leave anything to remember that you could automate,

Nikada ne ostavljajte ništa za pamćenje što biste mogli automatizirati,

whether it's scheduling it as recurring or saved list, or recurrent purchases.

zabilježite ponavljanje, spremljeni popis ili redovitu kupovinu.

Colocate.

Smještaj.

When it comes to exercise,

Kada je riječ o vježbanju,

store all the equipment that you need for a certain activity together,

svu opremu koja vam je potrebna za određenu aktivnost spremite zajedno,

charged and ready,

napunjenu i spremnu,

so you don't spend energy looking for it.

tako da ne trošite energiju tražeći.

And decrease temptations,

I smanjite iskušenja

for anyone driven by sugar cravings.

za svakoga koga vuče žudnja za šećerom.

Anyone?

Ima li takvih?

Say aye, go ahead.

Recite "da", samo naprijed.

That itself is its own form of Crazy Mode

To je samo za sebe vrsta "ludnice"

and self-medication for Crazy Mode,

ali i lijek za "ludnicu",

but stop working your willpower.

ali prestanite hraniti svoju volju.

Design differently.

Planirajte drugačije.

If a food is out of immediate reach,

Ako hrana nije na dohvat ruke,

such that you have to use a stool to reach it,

tako da morate koristiti stolicu da biste je dosegli,

even when it's chocolate,

čak i ako je čokolada,

study participants ate 70 percent less without thinking about it.

sudionici studije jeli su 70 posto manje ne razmišljajući o tom.

I know.

Znam.

Let that sit for a second.

Pustite da vam to sjedne.

(Laughter)

(Smijeh)

Design to make the choices you wish to make easier.

Planirajte kako biste olakšali izbore koje želite.

Which bring us to the third step to go from Crazy Mode to Ready Mode,

To nas dovodi do trećeg koraka za prelazak iz ludnice u stanje spremnosti,

and that is to get out of your head.

a to je da izađeš iz svoje glave.

Come with me.

Dođi sa mnom.

Different story.

Drugačija priča.

I'm working in a small, satellite ER,

Radim u maloj, područnoj Hitnoj,

when a woman comes in in labor.

ulazi žena koja rađa.

I realize that the cord is wrapped not once

Shvaćam da je vrpca omotana ne jednom

but twice around the baby's neck.

nego dvaput oko djetetova vrata.

And I'm the only doctor.

A ja sam jedini liječnik.

I was scared.

Bila sam prestrašena.

But I couldn't let it derail me.

Ali nisam mogla dopustiti da me to izbaci iz takta.

Because, you see, we all get nervous.

Jer, vidite, svi se nerviramo.

We all get scared,

Svi se uplašimo,

but it's what you do next that matters.

ali važno je ono što radite sljedeće.

That first feeling isn't the problem.

Taj prvi osjećaj nije problem.

It can be an important sign.

To može biti važan znak.

The problem comes when we let it derail us.

Problem dolazi kad dopustimo da nas izbaci iz takta.

When that internal monologue starts

Kad započne taj unutarnji monolog

and we catastrophize and we start to get that tunnel vision.

mislimo na najgore i počnemo dobivati ​​taj tunelski vid.

That's how you think when you're in Crazy Mode,

Tako mislite kad ste u stanju "ludnice",

and you cannot solve anything that way.

a na taj način ne možete ništa riješiti.

Now I promise to come back to the story,

Sada obećajem da ću se vratiti na priču,

but first, how do I get out of my own head?

ali prvo, kako da izađem iz vlastite glave?

There are many tactics that you may hear,

Možete čuti mnoge taktike,

but for me, I find it best in the moment to actively put my focus on someone else.

ali za mene je najbolje da se u trenutku aktivno usredotočim na nekoga drugog.

To deliberately make myself see the person in front of me,

Da se namjerno natjeram da vidim osobu ispred sebe,

see myself in the arena with them --

vidim sebe u areni s njima -

what do they need, what do they fear

što im treba, čega se boje

and how can I help?

i kako mogu pomoći?

This may sound like a whole lot of warm and fuzzy to you,

Možda vam ovo zvuči kao vrlo toplo i nejasno,

but it's not.

ali nije.

In fact, research shows that when you prime your brain

Ustvari, istraživanje pokazuje da kad ispunimo svoj mozak

with what is, essentially, compassion,

s onim što je, u biti, suosjećanje,

we disrupt that tunnel vision and internal monologue.

odbacujemo tunelski vid i unutarnji monolog.

You widen your perception,

Proširujete percepciju,

so your brain can actually take in broader information,

tako da vaš mozak može primiti šire informacije,

so you see more possibilities and can make better decisions.

pa vidite više mogućnosti i možete donositi bolje odluke.

Try it.

Probajte.

Know that your internal monologue can derail you.

Znajte da vas vaš unutarnji monolog može izbaciti iz tračnica.

And realize that when you get out of your own head,

I shvatite da kad izađete iz vlastite glave,

you get out of your own way.

sami se sebi sklanjate s puta.

Now what happened to that baby?

Što se dogodilo s tom bebom?

I focused not on my fear,

Nisam se usredotočila na svoj strah,

but on the mother and the baby and what they needed me to do.

nego na majku i dijete i ono što sam trebala učiniti.

And got the cord off of the baby's neck,

Skinula sam pupčanu vrpcu s bebinog vrata

and a healthy screaming, kicking baby arrived,

i stigla je zdrava, vrišteća, živahna beba,

just as the dad ran in from the parking lot,

baš kad je tata utrčao s parkirališta.

"Hi, you have a son, I'm Dr. Darria.

"Bok, imate sina, ja sam dr. Darria.

Congratulations, you want to cut the cord?"

Čestitam, želite prerezati pupčanu vrpcu?"

(Laughter)

(Smijeh)

And for a moment,

I na trenutak,

the strong cries of a newborn

snažni krikovi novorođenčeta

drowned out the beeps and the sirens that are the normal sounds of the ER.

ugasili su zvučne signale i sirene, što su normalni zvukovi na Hitnoj.

But there was also something else.

Ali bilo je tu još nešto.

Because when I walked back out of that mother's room,

Jer kad sam se vratila iz sobe te majke,

I saw several of my other patients hovering nearby.

ugledala sam nekoliko drugih pacijenata kako kruže u blizini.

I suddenly realized that despite their own problems

Odjednom sam shvatila da unatoč vlastitim problemima

that had brought them to the emergency room,

koji su ih doveli u hitnu,

they had all come together to root for this baby.

svi su se zajedno udružili navijati za ovo dijete.

And they now together shared in the joy.

A sada su zajedno dijelili radost.

Because that is what happens when you go from Crazy Mode to Ready Mode.

Jer to se događa kad prijeđete iz ludnice u stanje spremnosti.

Others notice.

Ostali to primijete.

They want it too, they just don't know how,

I oni to žele, samo ne znaju kako,

they just need one example.

potreban im je samo jedan primjer.

Which could be you.

Koji biste mogli biti vi.

Own the busy.

Vladajte zauzetošću.

But stop calling it crazy.

Ali prestanite je nazivati ​​ludnicom.

You've always had that ability.

Oduvijek ste imali tu sposobnost.

But now ...

Ali sad ...

you're ready.

sad ste spremni.

Thank you.

Hvala vam.

(Applause)

(Pljesak)