Older lady presents to ER,story not adding up,nurse detective,getting help,staying calm and professional through out the visit and team work in action.
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An older woman was writing her name on the clipboard. She winced as she wrote her name. I watched her from the triage window noticing her swollen wrist and her walking with slow unsure steps back to her seat. I pulled the clipboard in and pulled out her sticky note with her name. I called her in, into the small triage room. She came in with a young good looking muscular man. She told me that he was her son.
I asked her what happened and she told me that she tripped and fell down the stairs 2 days ago. The son said the same thing to me. I noticed the bruises on her arm and the wrist that looked like it was fractured. I also noted that she had a black eye. She told me that she got the black eye while she fell. The son was hovering around her listening to everything she was saying. My instincts were screaming at me as the story did not add up.
I asked her if she wanted something for pain and she nodded with tears in her eyes. I told the son that I wanted to get an X-ray and give her something for pain. I politely asked him to stay in the waiting room while I took care of his mother. I told him that I would give him an update as soon as I knew and though he was reluctant, I managed to get him back into the waiting room.
Once he left, I turned back to the patient, gave her pain medication as promised. I then asked her gently," Now tell me what really happened?"
Her voice quivering she told me that her son had twisted her arm and demanded her social security check to fund his drug habit. When she told him that she wanted to use the money to buy food and her BP medicines, he got angry and punched her in the eye. He then pushed her down the stairs. He was a correctional facility officer.
I was livid but had to stay calm and professional. She begged me not to tell anyone as he would hurt her if she did. I told her that since it was abuse, I had to share it with the team but would get her help without her son's knowledge. She was not happy and very nervous. While she was at X-ray, I alerted the team.
Since she refused to press charges and did not want us to call the cops, our options were limited. The social worker spoke to her and arranged for her sister to visit her the same day once she was discharged and get her out of the house. Her X-ray showed a fracture of the radius and wrist and she ended up with a cast and a follow up with orthopedics. The hardest thing for me was to give the son updates on his mother's status calmly while she was in the ER. The ER team was professional and never once betrayed the patient's confidence. While her son went to get his car, we hugged her and assured her that her sister would be waiting for her when she reached the house.
It was hard for us to see her go back with her son but we had to respect her wishes. The social worker followed up with a phone call , two days later and left a message for her to call back but she never did. I kept her in my prayers since then.
