I have a dear friend who I have known for 10 years. I attended and supported her through her two natural childbirths including one at home (just as the friend, not the midwife!- she had one of those). I have answered her called in the the middle of the night when she was a new mom and baby was crying or she was having trouble nursing. I was not a nurse then-- I am just now a new RN. We differ on a lot of things including the fact that I have put my trust in conventional medicine, esp after one of my children was born with a complex medical issue and needed lots of medical intervention that homeopathy would not have touched and may have even caused more harm.
So last year she called me saying her child was having some breathing trouble, fast respirations, retractions. I told her to immediately take her to the ER. She didn't listen. Finally a couple of days later she took her to the naturalpathic doctor, who called an ambulance from the office and the girl was admitted for several days with asthma. She was given instructions to give the child medicine and breathing tx, but has not done either. And yet she calls me all the time asking what she should do, and I always tell her to take the child in and she doesn't.
Last week she called again in the middle of the night. Her child had a high (103) fever for a few days which did not respond to Tylenol. She called only when the child was complaining of a stiff neck and was not lucid, seemed to be having hallucinations and was sleeping a lot in between these fitful waking periods. Once again I told her take the child to ER but she didn't. Instead she gave the child phosphorus which was something she had read about in a book. She also started to wake the child more often to offer fluids. The next AM she called to say the fever was gone and the child was better and she was glad she didn't bring the child in, they would have just done the spinal tap and put the child through needless suffering. I say she had a very close call with this child! It could have been serious. And to add insult, she changed to the subject of asthma since I have a cough right now, and suggested that the chiropractor could cure my asthma with a few adjustments! I have been suffering my whole life and know how to manage it with meds and doctor visits.
She's planning to go to a third world country with the children in a few months. I educated her once again about vaccines and encouraged at least the Dtap and polio. She did finally relent on those after me telling her horror stories of children I had seen in this same country when I traveled there several years ago. Polio is alive and well.
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I don't know why this friend keeps calling me. I don't know if I'm obligated, now that I'm an RN, to report her lack of action with a child who's ill, esp. the last time when it could have been very serious. I love her and I know she loves her children but it's just hard to watch. I know I have to report abuse but does this count as abuse?
Thanks for voicing some of my own thoughts-- it's a fine line to walk isn't it? She is a dear friend and we have a lot in common. Most of the time we meet for lunch without kids. I think I'll just tell her I can't listen to or answer advice about the kids medical issues anymore, because as an RN I am obligated to report things that she may not want me to report. If she tells me her child is not breathing well or could have meningitis or something I may have to call 911 if she won't take the child in if I feel its in danger at that moment. Hopefully that will keep her from consulting with me about medical issues anymore.
The father of the children lives in the household and I feel he is a lot more responsible that I would ever be in this type of situation. I wonder what he's doing half the time.
Dragging you ( a licensed nurse) into a situation (making you an accomplice) where a child is denied necessarry medical care is not something a FRIEND would do.
Her kid's symptoms strongly suggested meningitis & she ignored it. If it had been and was left untreated, that kid could have been dead within 24 hours. Or if she was lucky, the kid might have lived but had major limb amputations. I'm guessing this same mom probably skipped vaccines. These kind of people scare me and frustrate me to no end. I also think it's sad that our nursing textbooks suggest that we bend over backward to be politically correct with "alternative" treatments to not offend patients. And what's up with the official NANDA nursing diagnosis, "disturbed energy field?" Really???? We need to return to critical thinking and sound logic.
If this mom wants to look at real evidence about "alternative" treatments and practitioners who advocate them, I would suggest referring her to http://www.quackwatch.com/.
She was given instructions to give the child medicine and breathing tx, but has not done either. And yet she calls me all the time asking what she should do, and I always tell her to take the child in and she doesn't.
She has a child who had to be hospitalized for an asthma exacerbation, but is not giving the child the home treatments needed to prevent future exacerbations? This would earn her a social work consult at the very least at my hospital.
I don't think telling her not to share her medical concerns with you is the right thing to do. It likely won't change the way she manages her children's illnesses, and I am particularly concerned about the child with asthma. People do die from severe asthma attacks. I think you need to call CPS and have them investigate. They will determine whether her actions constitute neglect.
I would have a hard time being a 'friend' to this person-are the only times you interact when she needs 'medical' advice-that she seems to never take-why does she bother you?
It would drive me nuts that she may possibly be endangering her children!!!
If somebody kept asking my advice but not taking it, I'd stop giving advice. Advice by phone is a major risk to begin with, since you can't even see the patient. Nurses want to help people, but letting people play on that emotion by giving phone advice just places your license and the patient at risk. From now on just tell her to go to a doctor ASAP. Nothing more, nothing less. You've been incredibly patient and a good friend, but it's time to draw the line.
I like the idea of the poster who said next time she calls you with an emergency that she is looking for a way to rationalize ignoring, just call the ambulance to her house for her. It covers your butt and she'll get the picture, if you know what I mean.
just be aware, CPS is very aggressive (which can be good), sometimes to the point of accidentally destroying lives. a friend's son got hurt once, they took him to the ER being the good parents they are, the ER called CPS to investigate per their protocols, it took 9 hours of interviews in ER, a week for CPS to "clear" them and another 6 months to 1 year for CPS to stop harassing them. now they have a "record" and neither parent can volunteer or chaperone at their children's schools, they dont pass the background check!! it happened over 10 years ago!!! and yet, in nursing school i went to peds rotations, took care of a little girl who eventually died cause CPS kept sending her back to her abusive mom who beat her severely... cause "family is best"
If, God forbid, something were to happen to this child, and this were to end up in court it would be very easy for her to say "Well I asked Suzy and she's a nurse." Bye bye license.
There was a nurse in our area who did not report suspected abuse (medical neglect is abuse) and she faced jail time for it. Just another side to that coin.
Another timely example is Kristen LaBrie, the Mass. mother just convicted of murder for withholding chemo from her son. Immagine if she was in court and said, "But I talked to nurse so-and-so and she wasn't overly alarmed..." The tragic part about that child is that he had an 85-90% chance of being cured (from Non-Hodgin's Lymphoma). Meningitis would be viewed similarly by the court - it has a high cure rate if treated early, but a dismal rate if left untreated.
As an adult your friend is free to refuse medical treatments, although she's not legally able to refuse medical treatments to the same extent when it comes to her infant. Even Jehova's Witnesses are usually required to submit blood transfusions for their children by court orders unless the child is a "mature minor" and considered able to make those decisions for themselves, which is usually considered to be at least 12-14 years old.
Your license isn't on the line simply for having relationship with someone who is hesitant to use traditional medicine. You've encouraged her in the past to seek medical help when it seems appropriate which is consistent with "reasonable and prudent" behavior for a nurse, so you're license is safe, cutting off ties with her would just mean one less reasonable voice speaking for this infant.
cause "family is best" 
anon456, BSN, RN
3 Articles; 1,144 Posts
Thanks for voicing some of my own thoughts-- it's a fine line to walk isn't it? She is a dear friend and we have a lot in common. Most of the time we meet for lunch without kids. I think I'll just tell her I can't listen to or answer advice about the kids medical issues anymore, because as an RN I am obligated to report things that she may not want me to report. If she tells me her child is not breathing well or could have meningitis or something I may have to call 911 if she won't take the child in if I feel its in danger at that moment. Hopefully that will keep her from consulting with me about medical issues anymore.
The father of the children lives in the household and I feel he is a lot more responsible that I would ever be in this type of situation. I wonder what he's doing half the time.