Patient Confessions

licha · Nov 20, 2010

I definetely feel what you feel it is very hard to show empathy care and respect to patients that have not had this same respect for others. But this is how I handle it and I educate my staff to aproach it in this matter. I have 15 years of CNA experience, and 4 as an RN. I have dealt with convicted murderers on vents/ sex offenders with end stage Alzheimers, criminals in general on hospice,ect. You just have to make a mental block dont think that you are caring for the offender but for the disease; at first it is hard to do but there is no other way for we are nurses took an oath to assist the ill and that is exactly what we punch in to do. Regardless of race, gender, and in nursing we add social Hx to the list of discremination. We have to treat our patients equally regardless. Try not to think of it too much just focus on the healing process of the disease not the social part of it. Try it dont do too much research on the patients (for you will be surprised on what you find). Now if they try to confess (pretend and put your nursing cap on) and just listen with your eyes only let it come in one ear out the other. Perhaps offer a social worker or pastor if you dont want to know or hear the confession part of it. I hope that this helps. It is not easy at all nursing is what it is; NURSING the ILL :nurse: .

carolmaccas66, BSN, RN · Nov 20, 2010

I work a lot in mental health. Unless ur a mental health professional (and I'm still studying in this field myself), I would advise you very strongly not to get into a deep conversation with this person. Men that molest / think about molesting young women or girls IN MY EXPERIENCE ONLY are usually highly manipulative and disturbed individuals. They also usually lie re what they have done. U have no idea whether he was telling u the truth re this scenario, perhaps he did molest his daughter. Either way he is looking to get someone on his side to feel sorry for him. Don't get sucked in! Act like the professional you are, and take positive action. Firstly u need to report this to ur shift coordinator/supervisor/NM and get ur social worker involved, so they can contact child services. Always tell the patient what ur doing is part of the law & that as a health professional, u must report this to authorities. Do not comment on anything he says - it is all hearsay anyway. Here in Australia it is mandatory to report any abuse or people thinking re abuse towards under age children or young teens. I was in a similar situation one night when a drunk, extremely abusive, deranged man rung his partner in our psych unit, saying he was going to put his little boy where no-one would find him. It was an absolutely harrowing night but the boy ended up being safe.

This molester (even if he says he didn't do it) needs to be seen by a psychiatrist and police action taken. U need to ring the authorities today and report him. If u can't ever handle caring for these people, u need 2 let ur NM know ASAP.

I've cared for convicted paedophiles (when no other nurse would), and convicted murderers and will always warn others: these persons may SEEM like normal and chatty invididuals, but this is part of their charm to get u to put ur guard down! U can act professional but don't get into long, drawn out conversations. Always report anything unusual and get a mental health professional to assess them.

pedsrnjc · Nov 20, 2010

I have dealt with people who have done this type of thing. There is no forgiveness, but in a nursing home, with dementia, they are getting partial suffering (payback).

Some mother rocked this baby (or should have), this child grew up in a world that messed him up; he learned to cope the best he could. He hurt others, like everyone else he will die. IDK. Only by the grace of God are we not that person...

When I have to care for a particular yucky person, I try to picture them as a baby, innocent. At one time they were. I just keep trying to see the baby the evil person was and focus on caring for that innocent baby. It's not an easy task, I'm sure you will find your own ways to care for these people. We all find coping methods. Good luck.

Luv2care0907 · Nov 20, 2010

I am wondering what this man hoped to gain by his confession. But let's just assume that he genuinely wants a clear conscience. Perhaps he is dying and knows that he has something that needs to be made right. When someone is asking for forgiveness, they are not asking for approval of their actions and I think that is a huge problem in nursing today reconciling these issues. For example, would you feel the same if the confession and request for forgiveness concerned sex outside of marriage, homosexuality or abortion? We are taught that these are "alternative lifestyle" choices and would probably express that in our response. So when someone asks you to help them through the process of forgiveness, many of us think that we are to help ease the person's conscience through acceptance. Only now we have a new dilemma because there is no acceptance of these actions because as I have said before, everyone has a place where they draw the line. Sex toward a child is that line.

Here's the bottom line on this. In any of the above situations, you and I have no power to restore a conscience and clean someone up on the inside in order to reconcile them to God, which is what this man is apparently seeking. See, in my mind, his actions are no different than any other evil. If he is hoping for acceptance from you, he's wasting his time as well. I doubt there are any nurses that would offer him acceptance and understanding.

I want to propose something else here. I often wonder how many of these people are out there eaten up on the inside over these things they've done that have no hope of getting out of them. You talk about the unforgivable sin. In the minds of many people, this is it. So these people continue to be in bondage to these things and they end up hurting more and more people as a result. Even an alcoholic who kills a child while driving DUI has more mercy and understanding offered to him than the pedophile. I think both extremes are wrong.

Trying to understand the evils of this world is a dead end and not understanding the way of escape is the other. You won't find those answers in your nursing textbook. The original nurses knew how to respond but nowadays, we are forbidden to give those answers. I would redirect him back to the chaplain. I know what the answer is and I would assume the chaplain does too.

lilypad2424 · Nov 20, 2010

well said

Esme12, ASN, BSN, RN · Nov 20, 2010

If his daughter is a minor you are a mandated reporter. Go to your manager or supervisor IMMEDIATELY. If the daughter is not a minor tell the patient that while you appreciate his sharing what he told you makes you uncomfortable and you cannot discuss it any further. Tell him that you can offer him clergy or social service or psych if he feels the need to talk about it further but you cannot participate in the conversation. And still let your manager/supervisor know about his disclosure. Be Polite but firm that you will not participate in the "confession" any further. hope this helps!

**RosesrReder, BSN, MSN, RN** · Nov 20, 2010

I've worked in a prison and learned that no matter what I personally may think or not, I am there to take care of the individual. At this point, not hollistically. I don't want to know what they are there for or what they claim they are not.

I've taken care of prisoners at the hospital; same thing.

In your case, I'd report it if the daughter is a minor. I would also speak to spiritual care or whatever dept. there so that they can better help this man or at the very least 'entertain' him (allow him to vent).

Nursing care has to be adapted in the setting you work.

GL

CAT-CNA · Nov 20, 2010

I agree with the other posters. The last ltc I worked at we did have a resident who was a child molester (we also had a murderer who was paroled to the nursing home). My first day the molesters call light went off so I was about to go down the hall to answer it when one of the nurses yelled out "be careful with him, he is a child molester and he likes to try to grab butts" so of course I went back to the nurses station and asked "what do you mean" (I wasn't sure I heard her correctly, much less believe that she would shout that out for all to hear) so she told me that he molested a 3 yr old girl--totally messed up her insides. While this info made me ill and I did not like the resident at all, I still took care of him and I never let him know my true feelings about him. I did not care for him personally but I still cared for him as a resident because that was my job--to provide care. My best advice, like the others have said, just take care of him but I would not go further than you had gone with the previous conversation you had with him, and yes, if the girl is a minor--report it to your supervisor and let them take it from there.

nurse2033, MSN, RN · Nov 20, 2010

If his daughter is a minor you are a mandated reporter. Go to your manager or supervisor IMMEDIATELY. If the daughter is not a minor tell the patient that while you appreciate his sharing what he told you makes you uncomfortable and you cannot discuss it any further. Tell him that you can offer him clergy or social service or psych if he feels the need to talk about it further but you cannot participate in the conversation. And still let your manager/supervisor know about his disclosure. Be Polite but firm that you will not participate in the "confession" any further. hope this helps!

The statue of limitations would have long expired. It sounds like this happened in the 70s.

Kooky Korky, BSN, RN · Nov 20, 2010

Not too long ago I started a thread about what to say to patients who were anxious and depressed. I received a lot of great comments and advice but, I now ran into another issue tonight which has to do with the topic of this thread.
I went into this mans room and asked if he needed anything. He said he would like some ice water and juice and I got it for him. After I asked if he needed anything else he said yes, forgiveness. Naturally I asked what he wanted forgiveness for. He began to say that he was talking to the hospital chaplain and then started to go into his family life and some of his own. It was a pretty normal conversation until he mentioned that he did something really stupid back in the 70's and that's what he wanted forgiveness for. He said he tried to molest his daughter but stopped just in time. He then began to go on about how beautiful and smart this daughter was. I was just dumbfounded. The only thing that saved me was there was a fire drill at that moment and I had to leave to help close the doors.
I understand that working in the hospital you deal with all types including the most foul wastes of life but, they still need care. I just abhor child molesters and after hearing that I found it hard to care about anything that happened to this man. Now I don't want anyone to think that as a future RN if I ran into this situation again I would purposely cause harm to a patient with a twisted past because I wouldn't. I think I would just perform care without caring.
How do you handle patients like this if you know they committed horrible things? Have any patients confessed things to you that were unsettling?
P.S I would also like to give my deepest thanks to all who work with children and have to care for those who have suffered through things like molestation and abuse. How your hearts must ache some days.

Wow, perfect timing - saved by the bell!

Well, don't encourage the patients to confess to you. Tell them that their talks with you are not privileged the way talks with clergy and attorneys and physicians are. Tell them you want to help and will get the chaplain for them (good luck finding one) but that they really should not confess to you because you could be forced to divulge their information if you think someone is in danger or that a crime has been committed.

Also, he might have been sincere or he might have just been trying to get a reaction from you - which he did, it seems.

Next, try not to be horrified or angry. There are lots of very sick, evil, stupid people in the world. You'd be amazed and shocked if you knew half of what some people think, have done, or do. Just watch the cop shows on TV.

Lastly, you don't have to like each patient, care about them wholeheartedly, or do more than the bare required care for them. Just behave impartially, try to understand that God loves each and every one of them and He sent His only Son, Jesus, to die for this person's sins, just as Jesus died for your own sins. Sorry if my theology offends - it's what I believe and how I keep going each day. You don't have to agree, it's just what I believe. Anyway, remember that sinners need forgiveness, not anyone who is without sin. And God can heal their victims, too.

Kooky Korky, BSN, RN · Nov 20, 2010

I am wondering what this man hoped to gain by his confession. But let's just assume that he genuinely wants a clear conscience. Perhaps he is dying and knows that he has something that needs to be made right. When someone is asking for forgiveness, they are not asking for approval of their actions and I think that is a huge problem in nursing today reconciling these issues. For example, would you feel the same if the confession and request for forgiveness concerned sex outside of marriage, homosexuality or abortion? We are taught that these are "alternative lifestyle" choices and would probably express that in our response. So when someone asks you to help them through the process of forgiveness, many of us think that we are to help ease the person's conscience through acceptance. Only now we have a new dilemma because there is no acceptance of these actions because as I have said before, everyone has a place where they draw the line. Sex toward a child is that line.
Here's the bottom line on this. In any of the above situations, you and I have no power to restore a conscience and clean someone up on the inside in order to reconcile them to God, which is what this man is apparently seeking. See, in my mind, his actions are no different than any other evil. If he is hoping for acceptance from you, he's wasting his time as well. I doubt there are any nurses that would offer him acceptance and understanding.
I want to propose something else here. I often wonder how many of these people are out there eaten up on the inside over these things they've done that have no hope of getting out of them. You talk about the unforgivable sin. In the minds of many people, this is it. So these people continue to be in bondage to these things and they end up hurting more and more people as a result. Even an alcoholic who kills a child while driving DUI has more mercy and understanding offered to him than the pedophile. I think both extremes are wrong.
Trying to understand the evils of this world is a dead end and not understanding the way of escape is the other. You won't find those answers in your nursing textbook. The original nurses knew how to respond but nowadays, we are forbidden to give those answers. I would redirect him back to the chaplain. I know what the answer is and I would assume the chaplain does too.

What do you think is the answer?

Why are you forbidden to express your personal opinion, even if it is contrary to humanistic atheism and "anything goes" that are being forcibly taught in PUBLIC schools on tax dollars? Your 1st Amendment right does not end at the school or hospital door. Just let the person you are speaking to know it is your opinion, not any official view of your school or employer. Right?