Reads the person and the moment

Recognise and Reframe: Seeing Past the Label

A CORA decision skill · about a 4-minute read

“He is attention seeking.” “She is non-compliant.” Those are not descriptions of a person. They are descriptions of somebody else's frustration, and they get passed down a team until nobody questions them.

Recognise & Reframe means

See past deficit labels/assumptions to what's actually happening; correct an unhelpful frame.

What it looks like on shift

  • You hear a handover describe somebody as difficult, and you go in without that word in your head.
  • A behaviour written up as attention seeking turns out to be the only reliable way that person has of saying they are in pain.
  • You notice you have started using a word about someone that you would not use in front of them.

What it looks like when it slips

  • Inheriting a frame from a handover and then only seeing the evidence that fits it.
  • Treating a diagnosis as an explanation for everything a person does.
  • Describing what somebody cannot do when what changed is what you offered them.

One thing worth knowing about these words

Difficult, non-compliant, aggressive, attention seeking. These words do not get applied evenly. Whether somebody picks one up can have as much to do with how they communicate, and with who was writing the note that day, as with anything they actually did. That is not a comment on any individual worker. It is a pattern in the paperwork, and once a word is in there it follows a person from service to service.

Which makes it worth asking, when you inherit one of these words, who wrote it down first and what they actually saw that day.

Three things to try on your next shift

  1. When you catch a label in a handover, ask what actually happened. “What did that look like?” turns a judgement back into an observation.
  2. Try saying the sentence with the person in the room. If you would not, it is probably a frame rather than a fact.
  3. Swap one deficit word for a description this week. Not “aggressive” but “raised his voice and walked out”. It changes how the next person reads the note before they have even met them.

Where reframing stops

Reframing is about the words you carry in your head and the words you pass to the next worker. It is not licence to soften a record. If somebody declined their medication, that gets recorded as what it was, because a nurse or a prescriber may be relying on that word meaning one specific thing. Change the frame, not the accuracy.

And if what is actually sitting behind the label is pain, an injury, or somebody being hurt by another person, that is not a reframe. That goes up.

Before you act: Always follow your own organisation's policy first. For a suspected poisoning or medication error, the Poisons Information Centre is 13 11 26. In an emergency, call 000.

More in Reads the person and the moment:

  • Read the RoomClock the real emotional/behavioural signal under the surface and respond to that.
  • Spot the ChangeNotice shifts in health, mood or behaviour early.

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