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

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I have to wonder just why this thread was so popular? I don't think it was the critical thinking exercise that generated all the hits...

-HBS

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Specializes in ICU.

Don't kid yourself - there are an awful lot of nurses who like nothing more than a nice juicy case study - especially one with an ethical dilemma.

Don't kid yourself - there are an awful lot of nurses who like nothing more than a nice juicy case study - especially one with an ethical dilemma.

The more juice the more hits? Are nurses more thirsty for juice than other members of the general population? Sounds like a good research question!

-HBS

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The specifics are my concern--how many pts out there fit this scenario? The OP is very knowledgeable, and I respect her judgement. We still need to be careful, IMHO.

I agree, we need to be careful, but not excessively fearful. With the millions of "case studies" that exist, a person could make up anything or report anything and have SEVERAL individuals whose situations resemble that which is presented.

Case studies are the primary medium through which ethical standards evolve. They are essential.

Interesting case study. And interesting diversity of responses/theories. This entire thread is good fodder for an article in some Nursing Magazine. If this woman's husbands had life insurance policies which didn't exclude payment for suicide then I'd really wonder!

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.

And monitor HIS response to HER.

Savvy One

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.

And monitor HIS response to HER.

Savvy One

Specializes in ER, ICU, L&D, OR.

Interesting thought

I think

Specializes in ER, ICU, L&D, OR.

Interesting thought

I think

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

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

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

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