Black Eye w/ Fractured Arm - Mother Afraid of Son

  1. 18

    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.

    Black Eye w/ Fractured Arm - Mother Afraid of Son

    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.
    Last edit by Joe V on Nov 12, '15
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    About spotangel, BSN, MSN

    RN for 26 years.Worked med surgical, telemetry,ER,home care,LTC and management. Love being a nurse! Passionate about safe staffing!

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    14 Comments

  3. by   ebrooks1013
    *tears* When you have done all you can do...it still doesn't seem like enough.
  4. by   bebbercorn
    The moment when you ask, "are you safe in your home," and their mouth says yes, but their eyes say no ...
  5. by   hppygr8ful
    And as mandated reportes the hole ER staff was negligent for not calling the police and Adult protective services. They should be ashamed of themselves.
  6. by   spotangel
    The social worker did report it to the hotline number.We could not call the cops as the patient refused to press charges and did not want us to call the cops.She was alert and we would be violating her wishes and rights by ignoring her request..So a trusted family member(her younger sister) was notified ,who promised to be there, at her door when he pulled up. The plan was for the sister to take the patient to her house and take her out of the abusive situation. Sometimes life is not black and white and what would fit our moral code may not work out for the patient.
  7. by   KThurmond
    I'm glad you trusted your instincts and got the real story. Elderly abuse by family members is the worse because they never see it coming. I hope she healed up well and got out of the abusive situation.
  8. by   xoemmylouox
    Quote from spotangel
    The social worker did report it to the hotline number.We could not call the cops as the patient refused to press charges and did not want us to call the cops.She was alert and we would be violating her wishes and rights by ignoring her request..So a trusted family member(her younger sister) was notified ,who promised to be there, at her door when he pulled up. The plan was for the sister to take the patient to her house and take her out of the abusive situation. Sometimes life is not black and white and what would fit our moral code may not work out for the patient.
    This situation places them all at risk. I doubt that she left with her sister whom I'm guessing was elderly as well. I seriously doubt that the son was just going to let his drug money walk right out that door without a fight. There may be nothing else you can do, but reporting requirements vary from state to state. Some require that the police are contacted if there is suspect of abuse, even if the family says no. Similar to gun shot "accidents". They always have to be reported regardless of the circumstances when the elderly are involved.
    It's just sad when one thinks about how this happens a lot more often than we know.
  9. by   hppygr8ful
    Quote from spotangel
    The social worker did report it to the hotline number.We could not call the cops as the patient refused to press charges and did not want us to call the cops.She was alert and we would be violating her wishes and rights by ignoring her request..So a trusted family member(her younger sister) was notified ,who promised to be there, at her door when he pulled up. The plan was for the sister to take the patient to her house and take her out of the abusive situation. Sometimes life is not black and white and what would fit our moral code may not work out for the patient.
    The patient does not have to press charges in a case of assault - At least no in America - police can take a report and refer it to the DA who decides if the legal system will take action. Back when I worked Acute that lady would have been admitted and full body x-rays done to look for evidence of suspicious old fractures.
  10. by   BuckyBadgerRN
    That is a cop out excuse. The victim does NOT have to press charges in order for police notification. In my state, if the police are called regarding a domestic situation, SOMEONE is going to jail, it doesn't matter if the victim begs them not to.

    Quote from spotangel
    The social worker did report it to the hotline number.We could not call the cops as the patient refused to press charges and did not want us to call the cops.She was alert and we would be violating her wishes and rights by ignoring her request..So a trusted family member(her younger sister) was notified ,who promised to be there, at her door when he pulled up. The plan was for the sister to take the patient to her house and take her out of the abusive situation. Sometimes life is not black and white and what would fit our moral code may not work out for the patient.
  11. by   odaat
    Quote from BuckyBadgerRN
    That is a cop out excuse. The victim does NOT have to press charges in order for police notification. In my state, if the police are called regarding a domestic situation, SOMEONE is going to jail, it doesn't matter if the victim begs them not to.
    The problem with this is the perpetrator is usually released by the next day, nice and angry, and then what is the victim supposed to do? Hope a lil piece of paper (restraining order) protects them? This is a huge reason victims beg to have them not arrested. Its a bad situation with few good answers
  12. by   kristier
    Domestic abuse laws vary, but the elderly and children are protected classes in all 50 states. Just as a child doesn't get to decide if police are called, elderly people don't. In clear cases like this, the state is the plaintiff, the victim is the witness. And can be subpoenaed and compelled to testify. Sounds like an inservice day would be a good idea so your staff can be updated on reporting mandates.
  13. by   nursejoy1
    I work LTC and over the years we have had several sweet little ladies or gentleman that were being abused at home, usually by children, admitted to our facility under the protection of the county Department of Human Resources after someone reported the abuse or neglect. I cases of abuse, the family members are not allowed entry into our facility and in neglect cases, usually allowed supervised visits if the resident agrees. I agree that this should have been reported. If it were a child that said, "Please don't tell anyone" would the staff have respected their wishes? This is a similar situation in that this poor lady is dependent on her son and has NO control over anything.
  14. by   judihh
    Another sad story of elder abuse----A visit should be made to the home by social services. It should not end there. The visit can be made while the son is at work. Believe me, he will stop at nothing to get the drugs he wants !

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