Lying to your patient??? - page 2

My patient yesterday was a 21 y/o w/ multiple gunshot wounds. She was 34 weeks at the time, and the baby died. The problem is....the doctors have told her that her baby died, but her family is... Read More

  1. by   BabyRN2Be
    Yeah, Tazzi, that's why I'm asking. It wasn't clear from the post whether the baby was delivered at 34 weeks and didn't make it, or they guessed that she was 3-4 months pregnant, didn't hear heart tones, and didn't want to add to her immediate problems by waiting for a natural m/c.

    By pictures, I sort of had u/s pics in mind, and it would make sense to have u/s pics done when associated with trauma such as GSW, and when you are in early pregnancy, those pictures mean so much and she asked to see them.

    Well, I guess any stage in pregnancy they mean so much, but when you are early pregnant and you don't have really tangible evidence of pregnancy (other than m/s and other symptoms) and those pics are all you have that you pregnant. I was wondering if she had asked for those if she was 3-4 months pregnant and just grasping the idea of everything.

    Either way, it's a tough situation for all involved and I pray that the right thing is done. For me, I don't have a clear picture of what went on, where she was gestationally, her acuity level, etc. But she does need to be told by the family. Maybe they have another reason for waiting to tell her of the demise? If someone has a chance, I'd ask the family why they are being so circumspect about the loss. If it's for her acuity level, I can sort of understand that. However, if her acuity is not in question, then waiting isn't going to make it any better and she needs to start grieving now.
  2. by   TraumaICURN
    Quote from BabyRN2Be
    There's a few things I just wanted to get clarified so I have a more accurate picture. In the original post it was stated that she was "34 months" pregnant. I'm really not trying to be flip, but was it meant that she was 3-4 months pregnant or 34 weeks?

    Has the baby been delivered if it was at 34 weeks? Or are they buying time for her by letting a natural m/c to take place?
    I'm sorry for the mistake! She was 34 weeks. One of the gunshot wounds was to her stomach, which killed the baby.
  3. by   TazziRN
    Aww............that's just downright cruel for the family to lie to her then. Somehow it seems worse with a viable baby than a small fetus.

    I remember I once got an elderly lady by ambulance who had been driving when she turned in front of another car and was t-boned on the passenger side. Her husband was in that seat and died on impact. She kept asking me about her husband and I was vague, just saying that I didn't know about him and that he hadn't been brought into this ER (true). When the highway patrolman showed up I grabbed him and told him what I had told her. Imagine my total shock and fury when, less than a minute later, we walked into the room and he told the woman her husband was in the other room!!!! I was too angry to ask him why he had done that.
  4. by   LilPeanut
    We had a lecture on this actually in one of our classes - Paternalism, the belief that you have to shield or protect the pt/family from the truth because they can't handle it. (it's wrong because it's not your place to judge that, you are supposed to just be there to provide info and support)

    Tough situation though, my heart goes out to that mom, and I think it is so much worse that her family is lying to her - What about the funeral? Are they going to deny the mother the chance to attend the funeral for her own child???
  5. by   BabyRN2Be
    Quote from TraumaICURN
    I'm sorry for the mistake! She was 34 weeks. One of the gunshot wounds was to her stomach, which killed the baby.
    Thanks for clearing that up Trauma! And I should have thought "weeks" as there aren't too many medical people who go by strictly months anymore.

    Wow, I'm sorry for the baby, and I'm even more sorry for the mom. By all means she should be told the truth. It would be wrong for the family to keep this from her even though they are coming to grips with the tragedy. They do need to be the ones to tell her so she doesn't harbor any resentment in years to come as to why she wasn't told the truth.