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

Specializes in Oncology, Cardiology, ER, L/D.
Now that got my mind going...

We have another victim/patient that alot of us were not even considering. Lets say the woman is innocent. Could you imagine the trauma she is going through? This woman needs help as well.

That is a really good point, I never thought of that, darn me and my little ol' suspicious mind.... Actually, if this woman is completely innocent, then I would definitely say she has some codependent issues going on! What a great thread HB! I will modify my original position and hope that both patient and wife can get that help they need.

Specializes in Oncology, Cardiology, ER, L/D.
not medically competent or not communicationg?

I would think both in this case, obviously the poor man was not in his right mind or he wouldn't have shot half of his face off and two, I think HB said he wasn't A & O but I might have read it wrong.

I would think both in this case, obviously the poor man was not in his right mind or he wouldn't have shot half of his face off and two, I think HB said he wasn't A & O but I might have read it wrong.

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

Specializes in Oncology, Cardiology, ER, L/D.

Thanks HB, I posted before I finished reading. Then, I have to modify my recently modified position( :p ) and say that I will have to go back to my ol' suspicious mind's original way of thinking! :) BTW, thanks again HB for such a thought provoking thread.

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

thought provoking

the roles were reversed and the pt was a woman who was wife number 2 out of 3 suicide???

I personally have been a thankful CODA member...and have seen many lurid examples of females who are charismatically evil and abusive (more males though...).

I am here to learn more so that I can be the best nurse for my pts as possible. Thank you for posting this thought-provoking case.

I strongly feel that Verbal Abuse by Patricia Evans should be required reading esp. for nurses.

She would have to be some screwy lady to live through 2 husbands killinh themselves and a third trying~ that is if she hasnt dont anything to them. I feel bad for her family, if she has one thats still around.

I think it was very interesting how the problems presented in this case study were perceived and acted on through questions and recommendations. Fascinating indeed.

-HBS

I think it was very interesting how the problems presented in this case study were perceived and acted on through questions and recommendations. Fascinating indeed.

-HBS[/quote

have you ever considered becoming an author? you truly know how to captivate your audience. 'fascinating indeed'. and we thank you.

forgot to ask hb, did you reconstruct this guy's face? will you do mine? you can make me into a regular old smiley face w/cheekbones and full lips and wrinkles only around my eyes because i've smiled so much. and you can't charge me because i am your case study.

ok...i'm thinking innocent until proven guilty. unless there is some legal action that is in the process of barring her visitation who can dissallow her visits? she is legally his wife.

forgot to ask hb, did you reconstruct this guy's face? will you do mine? you can make me into a regular old smiley face w/cheekbones and full lips and wrinkles only around my eyes because i've smiled so much. and you can't charge me because i am your case study.

The facial reconstructions I do are not a pleasant surgical endeavor to endure. Trust me, you want to make the most of the beautiful and handsome features that Mother Nature gave you!

-HBS

:)

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