what would you have done?

[_anonymous_]

Last night in A&E, a 21 y/o female presented to us, with a letter written by herself saying she had taken an overdose (small quantities of sertraline and paracetamol, but enough to need to monitor). When the duty dr listened to her back, there were obviously bruises. Some irregularity heard in heart beat, so I was asked to carry out an ecg. Once she was undressed and in a gown, I noticed that she was bleeding (appeared to be pv) and had bruises on her legs. When questioned, she refused exam and would not talk about what had happened. On the advice of dr, I left the situation, and just dealt with the overdose. Now I am thinking that I should have tried harder to help this woman. What would you all have done?

[bahamabread]

Document........document.........document. Write down the bruises you saw..........mention you pointed it out to dr. Write down his/her response. Could you have told a nursing supervisor? If your gut said something was wrong..act on it........then dont worry if you overstep the dr. Thats your job. Patient advocate. Not Dr advocate. At least you would have something documented for future visits.

[_anonymous_]

I documented everything, but I still feel like it wasn't enough. She wasn't the most talkative of patients, and to be honest, I think she was probably younger than she said she was. I didn't tell my lead nurse because she wasn't avaliable. I know I should let it go, but what have I sent her back to?

[SuesquatchRN, BSN, RN]

But what can you do, short of restraining her? Which, like, you can't.

You have to let it go. You can't save someone who doesn't want to be saved, and you can't commit people because you're worried about them.

[tlhubbard]

Working a pediatric ER, I know your pain. I had a patient who's obviously intoxicated father and father's girlfriend had brought in a small boy. They wanted him seen for a "rash" on his "BIRD". The rash was also on his hands and bottom. (strange combination) Dad then wants me to "feel" the rash and while he is holding the boy's "BIRD" he makes eating sounds and puts his mouth close to it. HORRIFIED, I went to get Social Services ASAP. Of course, dad and girlfriend denied (the boy was 3 1/2 maybe 4), so the rest of the night the dad followed me through the ER giving "looks" that would kill.

What this boy went back to heaven only knows. I finally came to terms with the fact I could only do what I could do. It's hard to let it go. Why Social Services took the word of an obviously drunk and stoned parent over a sober and licensed nurse I will never understand. I hope you are able to let it go eventually. Maybe you should talk to that nurse who wasn't available before, so future situations will be a little easier. She may have some good suggestions for some options.

[_anonymous_]

Thank you all for your replies. I guess that I have no choice but to let it go. Should this situation arise again, what do you think I should do? I will also talk to my supervisor about this asap.