Consequences of Bad Choices - page 2

I was recently involved in a multidisciplinary team evaluation of a patient who attempted suicide by placing a shotgun in his mouth. He survived the attempt but was left with only half a face. I... Read More

  1. by   colleen10
    I am a woman and feel that this is all very suspicious.

    Even if this woman is innocent of any direct involvement in the suicides of her previous husbands and attempted suicide of said current husband, something more is still going on. Perhaps she is NOT innocent in pushing these men over the edge, ie. emotional abuse.

    Obviously this patient is in an extremely fragile state of mind. As healthcare practioners we are responsible to care for all areas of the patient - mind, body and spirit. You must protect your patient's well being. Just because the police have not charged her and don't consider her a suspect doesn't mean that she doesn't play some role. I would vote to closely monitor her interactions with her husband until the theory of her involvement can be disproved.

    Unless she is literally meeting these men in some sort of 12 step group for people suffering from suicidal tendenancies something very out of the ordinary is going on.
  2. by   Sheri257
    Quote from hbscott
    I can understand and appreciate the concerns about privacy violations in accordance with the Privacy Act of 1974 and more recent and ever evolving HIPAA legislation. That being said I can assure you there are no HIPAA violations here in this post so far. If you need to do some research on just exactly what constitutes a HIPAA violation may I humbly suggest the following link:

    http://www.hipaa.org/

    But be warned, it is a very long read....

    -HBS
    I find this fascinating, since it reminds me of my journalism days. Even if you kept a source anonymous, as promised, you always had to careful not to mention other information that would, essentially, give their identity away. Technically, you could say you didn't name the source. But, if you really wanted to protect their anonymity, you had to be careful not to disclose anything else that could point to them.

    Just wondering what your thoughts are on this, HBS, since this case is so unusual. Even if it isn't a technical violation, isn't there a bit of a risk here?
  3. by   hbscott
    Quote from colleen10
    I am a woman and feel that this is all very suspicious.

    Even if this woman is innocent of any direct involvement in the suicides of her previous husbands and attempted suicide of said current husband, something more is still going on. Perhaps she is NOT innocent in pushing these men over the edge, ie. emotional abuse.

    Obviously this patient is in an extremely fragile state of mind. As healthcare practioners we are responsible to care for all areas of the patient - mind, body and spirit. You must protect your patient's well being. Just because the police have not charged her and don't consider her a suspect doesn't mean that she doesn't play some role. I would vote to closely monitor her interactions with her husband until the theory of her involvement can be disproved.

    Unless she is literally meeting these men in some sort of 12 step group for people suffering from suicidal tendenancies something very out of the ordinary is going on.
    Thank You! This is the type of input I was seeking and hoping to benefit from. The care team just wants to do "right" by the patient and is seeking a good outcome. This patient care scenario has a situational dynamic not usually seen or managed in my practice. This is why I presented this case study to the group. I was seeking professional guidance and the feedback presented here can be used in positive way if so allowed.

    -HBS
  4. by   nurseunderwater
    i suppose that is why i was wondering about it too. it's in the dc area...3 times, gsw to the head....it's just so unusual i should think it would be easy to track down..i dunno....just thinking.
  5. by   hbscott
    Quote from lizz
    Just wondering what your thoughts are on this, HBS, since this case is so unusual. Even if it isn't a technical violation, isn't there a bit of a risk here?
    Good Point! I have considered all possibilities as you have noted and have very carefully shielded the unique facts about this case. If I could be more forthcoming on exactly how I have done that then there would be risks involved in revealing too much. I will tell you that I do see patients from multiple and remote geographical locations due to the unique advanced imaging and reconstruction (plastic surgery) work I do. And I do travel...

    -HBS
    Last edit by hbscott on Mar 15, '04
  6. by   hbscott
    Quote from nurseunderwater
    i suppose that is why i was wondering about it too. it's in the dc area...3 times, gsw to the head....it's just so unusual i should think it would be easy to track down..i dunno....just thinking.
    As noted in another post I can assure you this case is not in the DC area. You made a false assumption based upon my profile which may or may not be accurate. Good guess though! But wrong nonetheless...

    -HBS
  7. by   TexasNS
    Personally I do think it is odd but I will try to present a different point of view. I think it is extreamly plausable that a woman could find three men that would eventually commit or attempt suicide. This of course would be on the extreme side of co-dependancy. What an awsome case to learn from though. Emotional abuse is very possible but I dont think there would be three that would go to that extreme. Maybe one but surely the others would just leave. But on the other hand for 1 woman to seek out "broken people" and try and be their healer (co-dependant) is very possible. Give the visitation monitered and see what can be learned about her personality.
  8. by   hbscott
    Quote from TexasNS
    Personally I do think it is odd but I will try to present a different point of view. I think it is extreamly plausable that a woman could find three men that would eventually commit or attempt suicide. This of course would be on the extreme side of co-dependancy. What an awsome case to learn from though. Emotional abuse is very possible but I dont think there would be three that would go to that extreme. Maybe one but surely the others would just leave. But on the other hand for 1 woman to seek out "broken people" and try and be their healer (co-dependant) is very possible. Give the visitation monitered and see what can be learned about her personality.
    Very interesting perspective and one I had not considered until now.

    -HBS
  9. by   leslie :-D
    sticking to the subject at hand, there's an intangible restlessness among this team, re: the wife's involvement. since she has not been named a suspect then i would think she legally can visit with him. i would have this woman supervised (since i do find it very suspicious) with her husband but again, am unsure on how this would infringe upon her legal/constitutional rights.
  10. by   hbscott
    Quote from earle58
    sticking to the subject at hand, there's an intangible restlessness among this team, re: the wife's involvement. since she has not been named a suspect then i would think she legally can visit with him. i would have this woman supervised (since i do find it very suspicious) with her husband but again, am unsure on how this would infringe upon her legal/constitutional rights.
    I think what makes the care team nervous is the wife. Will she be helpful or hurtful in our attempts to recover the patient. That is the question being raised at this time. Remember we have a duty to the patient first.

    -HBS
  11. by   leslie :-D
    Quote from hbscott
    I think what makes the care team nervous is the wife. Will she be helpful or hurtful in our attempts to recover the patient. That is the question being raised at this time. Remember we have a duty to the patient first.

    -HBS
    duly noted. but if the care team ultimately decides she will be hurtful, then on what grounds can you deny her access for visitation without being legally implicated?
  12. by   Stitchie
    I think you may be able to allow the wife visitation but in a carefully controlled setting; either with a sitter or some sort of monitoring that she won't be cognizant of, like cameras in e-ICU's or certain psych rooms. I also find it extremely odd that she would find three such damaged men and these circumstances shouldn't be ignored. While our duty is to our patient first, I think our duty to the patient involves keeping him safe. You could probably allow her to visit but I certainly wouldn't leave her alone with him while he's so vulnerable.

    I don't really believe in coincidences to this degree, and for this patient's sake I say she's guilty by suspicion until proven otherwise. It's like the moms with Munchausen by proxy thing going on with their children.

    I, for one, would love to know how this turns out. Best of luck to this unfortunate soul. How lucky he is that you have such a cool job!
  13. by   ktwlpn
    Quote from hbscott
    I can understand and appreciate the concerns about privacy violations in accordance with the Privacy Act of 1974 and more recent and ever evolving HIPAA legislation. That being said I can assure you there are no HIPAA violations here in this post so far. If you need to do some research on just exactly what constitutes a HIPAA violation may I humbly suggest the following link:

    http://www.hipaa.org/

    But be warned, it is a very long read....

    -HBS
    It might not fall exactly under HIPPA but when you post to a board like this,revealing where you are from in your profile and a link to your homepage that shows pictures of you and your family you sorta blew your anonimity,ya know? Anyone in your organization could be a member here....You have to be very careful-members have had problems at their places of employment from their participation on this board......

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