I work as an ER nurse. I encountered a parent who brought a child in to be evaluated because the child suddenly developed heart palpitations. The child was complaining of a racing heart. After evaluation it turned out their heart was beating well above the normal range. The child was awake, and responding appropriately, the other vitals were good.
I informed the doctor immediately and was later given verbal orders. I then let the parent know that we needed labs, I was informed by the parent that the child admitted to taking a piece of an Edible brownie laced with marijuana.
The parent states that they themselves had consumed the brownie but wasn't aware that the child had come in contact with it. I told the doctor that I needed to contact DCFS due to the fact that a minor ingested a drug laced brownie. The doctor didn't think it was necessary and wanted to immediately discharge. Drug test was positive for THC. I contacted DCFS.
What could have been done differently?
Staff note.... This has been edited and may not reflect in the initial replies
Just thinking - is not the doctor held to same responsibilities as a 'mandated reporter'? I mean, they have a license too. And 'do no harm' doesn't exactly mean IGNORE!
Just thinking - is not the doctor held to same responsibilities as a 'mandated reporter'? I mean, they have a license too. And 'do no harm' doesn't exactly mean IGNORE!
Yes, you're right. Makes you wonder how many other patients like this have come in and it hasn't been reported.
It sounds like what you want is reassurance that you did the right thing. Several people have expressed that they wouldn’t have reported this. You got angry and defensive. So, it is what it is.
It sounds like what you want is reassurance that you did the right thing. Several people have expressed that they wouldn’t have reported this. You got angry and defensive. So, it is what it is.
No I wasn’t angry I was just trying to make my point loud and clear and also yes I was defending myself. I didn’t need reassurance, I know I did the right thing. I wanted other people’s opinion because I got a lot of push back from the doctor. Also a little bothered by the fact that a lot of people didn’t see why this was reportable. It worries me that there are kids are out there who may be in danger and this kind of situation would be overlooked by the majority of people. A little sad to say the least. If you ask any lawyer they would tell you to report something like this.
My question for everyone is what if the 13 year old child had gotten a hold of heroin or cocaine instead of marijuana. Would you think it was reportable?
I have reported an abuse case in which the doc disagreed. She is smart, well intentioned, and well educated.
But- her opinion did not release me from my obligation. there is nothing in the wording of the lae in my state that has anything to do with the opinion of another professional.
Specializes in Psychiatry, Community, Nurse Manager, hospice.
On 4/27/2020 at 12:50 AM, dream'n said:
OK, I posed this situation to an adolescent psychiatrist that I personally know. Their response was "why didn't they speak with the mother about keeping marijuana out of the teens access? And unless this was a repeat occurrence, I don't see this as a reportable offense."
But the fact that you believe it is reportable, makes all the difference. Reporting this is your belief and your understanding of the law, therefore you did what was correct. All of us speculating weren't there, and you did what you felt is best.
I 100% agree with this statement.
I personally, would not have suspected abuse or neglect in this case. But if that is how you feel about it, you have a duty to report. DCFS will figure it out.
I personally, would not have suspected abuse or neglect in this case. But if that is how you feel about it, you have a duty to report. DCFS will figure it out.
Do you mind explaining why? just curious?? Please Present your rebuttal. How would you explain your reasoning in the court of law?
It sounds like what you want is reassurance that you did the right thing. Several people have expressed that they wouldn’t have reported this. You got angry and defensive. So, it is what it is.
What would be your rationale for not reporting ? I just want opinions. Let all have a friendly conversation.
On 4/27/2020 at 5:28 AM, hherrn said:
To be clear about your relationship with the doc-
Sounds like you ordered something you know he doesn't want then documenting that he ordered it.
That could be a problem.
As far as whether the doc thinks something should or should not be reported does not alter your status as a mandatory reporter.
would you report this, why or why Not ? Feel free to rebuttal.
Assuming you’re in a state where it is legal - if the kid had ingested, for example, their parent’s lisinopril instead, would you have reported it? Or was it the fact that it was an edible? I’m just genuinely curious what type of impact that would have.
For what it’s worth, I don’t think what you did was wrong. You did what you felt was appropriate.
As a pediatric nurse how would you explain to a lawyer your reasoning for reporting or not reporting?
Honest answers: did you order the drug screen with the Drs consent? I don't work in an ER or actually have taken care of patients for a long time, so I may be wrong about state reportables, but I doubt I would have called DCFS for this. A 13 year old positive for Marijuana? It's legal in my state to have marijuana in the home for adults and 13 year olds, well they aren't always the most upfront and truthful. I think the mom showed some responsibility by bringing the teen in for evaluation.
What's your rationale for not reporting this situation. How would you explain this to a group of nursing students, asking you the same question ?
2 hours ago, CommunityRNBSN said:
It sounds like what you want is reassurance that you did the right thing. Several people have expressed that they wouldn’t have reported this. You got angry and defensive. So, it is what it is.
Specializes in Psychiatry, Community, Nurse Manager, hospice.
3 minutes ago, Rasberry_RN_ said:
Do you mind explaining why? just curious??
Sure.
To me, a kid taking a bite of his parent's pot brownie is not neglect or abuse on the part of the parent, and the parent did the right thing by bringing the kid to the ER.
If the parent refused medical treatment for the child, or gave the kid the pot brownie, I would feel differently.
The fact that the parent eats pot brownies is not neglect. This was a kid taking something he shouldn't have either knowingly or unknowingly.
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amoLucia
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Just thinking - is not the doctor held to same responsibilities as a 'mandated reporter'? I mean, they have a license too. And 'do no harm' doesn't exactly mean IGNORE!