Consequences of Bad Choices

Nurses General Nursing

Published

  1. Of the following criteria what has the greatest influence in your nursing practice?

    • 41
      Ethical Considerations
    • 12
      Legal Considerations
    • 31
      Sense of Duty
    • 6
      Self Preservation

90 members have participated

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 was consulted as my department does advanced 3D imaging work to include prosthetic reconstruction of such profound defects.

As I was sitting in this team meeting a question was raised by a social worker on the visitation rights for his wife. The social worker reported that this woman had been married twice before and both previous husbands had successfully committed suicide. This was husband number 3 who had survived his suicide attempt and the wife wanted to visit her husband to "comfort" him.

The question raised to the care team was the wife a danger to her husband knowing the general history as outlined above. We were not privy to all the details but there was some suspicion that the patient's wife may have been a contributing factor to the suicide attempt. I was surprised to see that the care team had differing opinions on this matter that pretty much split down gender lines. I found this interesting.

The men on this particular care team felt that visitation for the wife should be carefully monitored until it could be determined that the wife was not a contributing factor to the patient's suicide attempt. The women on the care team felt that since she had not been arrested by law enforcement that the question was irrelevant. In fact one member stated that perhaps the only thing she is guilty of is making bad choices. It wasn't her fault that the men she chose to marry kept killing themselves.

Since this BB is a wonderful place to sample such diverse, well educated and experienced opinion I thought it would be an interesting case study to present.

Any thoughts?

-HBS

choices.jpg

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 was consulted as my department does advanced 3D imaging work to include prosthetic reconstruction of such profound defects.

As I was sitting in this team meeting a question was raised by a social worker on the visitation rights for his wife. The social worker reported that this woman had been married twice before and both previous husbands had successfully committed suicide. This was husband number 3 who had survived his suicide attempt and the wife wanted to visit her husband to "comfort" him.

The question raised to the care team was the wife a danger to her husband knowing the general history as outlined above. We were not privy to all the details but there was some suspicion that the patient's wife may have been a contributing factor to the suicide attempt. I was surprised to see that the care team had differing opinions on this matter that pretty much split down gender lines. I found this interesting.

The men on this particular care team felt that visitation for the wife should be carefully monitored until it could be determined that the wife was not a contributing factor to the patient's suicide attempt. The women on the care team felt that since she had not been arrested by law enforcement that the question was irrelevant. In fact one member stated that perhaps the only thing she is guilty of is making bad choices. It wasn't her fault that the men she chose to marry kept killing themselves.

Since this BB is a wonderful place to sample such diverse, well educated and experienced opinion I thought it would be an interesting case study to present.

Any thoughts?

-HBS

choices.jpg

I would be extremely suspicious of the wife. Just because she hasn't been arrested doesn't mean the police didn't suspect her;perhaps they had no hardcore evidence. I would contact the police(again) and report my suspicions and ask them to continue an investigation. This sure sounds too coincidental that all husbands commited/attempted suicide. Be interesting to know what she gained from their deaths as that would give the police something to look into. Visits with her husband should be monitored closely! Keep us informed. Darla

has anyone asked the patient his opinion?

has anyone asked the patient his opinion?

has anyone asked the patient his opinion?

The patient left the hospital quite bitter at his ex-wife for many different reasons.

The wife was never meaningfully interviewed so only speculation exists on her point of view or motivation.

Hospital staff knowledgeable about this case still expresses markedly split opinions on the wife's role (actual or potential) in the events that lead to husband #3's attempted suicide.

-HBS

has anyone asked the patient his opinion?

The patient left the hospital quite bitter at his ex-wife for many different reasons.

The wife was never meaningfully interviewed so only speculation exists on her point of view or motivation.

Hospital staff knowledgeable about this case still expresses markedly split opinions on the wife's role (actual or potential) in the events that lead to husband #3's attempted suicide.

-HBS

One more time for review....

The Rest of the Story

Now that I got everybody thinking it is time to reveal the rest of the story. I consulted on this case a little farther back than what most people thought. In fact this patient has been treated and released. He has a new face and a 2nd chance at life.

While the patient was unconscious the wife was allowed monitored visits and when the patient was fully alert and oriented he chose to meet with his wife in an area off the hospital floor he was staying. His wife would bring him things from time to time but one day she just stopped coming by. The patient soon discovered that his joint checking and savings account had been emptied and his soon to be ex-wife had run off with her girlfriend.

I wanted to present this "case study" as an example to some of our students on the practice dilemmas they will sometimes face in their various working environments. This case study is currently being published in several journals. I thought I would share it with our audience since nursing care was an essential component of his recovery.

The wife was consulted but remained distant to the care team. In my opinion mutual trust was never established with the wife and that prevented any progress for providing care and treatment to her if so indicated.

-HBS

Thanks for putting this one out here. It got us all thinking....Would love to read it once it is published.

One more time for review....

The Rest of the Story

Now that I got everybody thinking it is time to reveal the rest of the story. I consulted on this case a little farther back than what most people thought. In fact this patient has been treated and released. He has a new face and a 2nd chance at life.

While the patient was unconscious the wife was allowed monitored visits and when the patient was fully alert and oriented he chose to meet with his wife in an area off the hospital floor he was staying. His wife would bring him things from time to time but one day she just stopped coming by. The patient soon discovered that his joint checking and savings account had been emptied and his soon to be ex-wife had run off with her girlfriend.

I wanted to present this "case study" as an example to some of our students on the practice dilemmas they will sometimes face in their various working environments. This case study is currently being published in several journals. I thought I would share it with our audience since nursing care was an essential component of his recovery.

The wife was consulted but remained distant to the care team. In my opinion mutual trust was never established with the wife and that prevented any progress for providing care and treatment to her if so indicated.

-HBS

Thanks for putting this one out here. It got us all thinking....Would love to read it once it is published.

I am concerned about HIPAA re: this discussion.

YES I agree! too much info. ?professional

And, the comment -my job is easy I just have to rebuild his face- this makes me wonder if the writer is feeling a bit self-important.

Ignorance is the curse of God; knowledge is the wing wherewith we fly to heaven.

William Shakespeare

> -CEO

This case study has been carefully presented. No patient demographics, location and/or health care providers have been personally identified. No privacy rules have been violated implicitly or explicitly. The patient in this case study was fully informed that his case could be published and the patient signed consent forms acknowledging same.

Professional Journals (medical, nursing, allied health) are filled with case studies that teach health care professionals many important lessons that are derived from the practice setting. This case study is no different.

The anecdotal presented here illustrates the power of choices both in our personal and professional lives. There are consequences to our choices (some good, some bad) and sometimes the situation we find ourselves in requires a little critical thinking to sort out the various issues that we are faced with.

-HBS

Specializes in Trauma,ER,CCU/OHU/Nsg Ed/Nsg Research.
YES I agree! too much info. ?professional

And, the comment -my job is easy I just have to rebuild his face- this makes me wonder if the writer is feeling a bit self-important.

And your sig line (CEO) is not a bit self- important? The OP has a right to be proud of the job s/he has. It shows great job satisfaction, doesn't it? Do you want the nurses in the hospital you're a CEO of to not high 5 each other every time they save a life, or prevent an injury, etc? Why shouldn't we be proud of our accomplishments? Having worked with a patient myself, who had to have a facial prosthesis (entirely different circumstances, though), I find the whole process of that industry fascinating.

I also felt the case was presented in a professional manner. Thanks, HB- as a nurse, I LIKE the threads that make me think.

On a side note: It's our hospital's policy to have sitters with all suicide attempt patients, no matter the circumstances surrounding the event. This could be another way to have "supervised" visitation by questionable people on a medical floor.

Specializes in Registered Nurse.

I agree with CCU NRS. I would say observation is the best way to go.

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