Tomcat33 Posted July 22, 2008 Share Posted July 22, 2008 Think of how the depression must affect her is that really stretch? To think the depression this woman must be feeling has completely consumed her emotionally too? Your arguments are weak, at best, Tomcat. If that is the best you can up with to support your stance then I really have nothing to worry about. I don't care to argue anything, I was sincerely looking for solutions on how to handle the removal. And so far nothing. Well no not nothing. Chinook thanks for coming back to post I appreciate your thoughts. Link to post Share on other sites
Chinook Posted July 22, 2008 Share Posted July 22, 2008 That's what I'm talking about patients do become attached... Yes, that's very true. But my point in my post is that the patient's H... simply by extension of the situation is also attached to the OP due to the situation. In this case there is none of that, it is woman to woman closeness. And I don't see how that can be avoided when you are tending so closely to someone like in this situation? Yes, agreed - but see my point above. This situation is not as unique as some posters are trying to make out. As nurses we care for a whole range of long-term care patients who may be paralysed and cannot communicate. Then it is natural to communicate on behalf of and with the patient's family... namely the H in this instance. As you mentioned the woman-to-woman contact is not sexually or romantically an issue in this case. But what is an issue is that the woman is not brain dead and is able to make sense of body language and her nurse's demeanor. It's important that if a relationship with the H persists, the nurse remove herself from this whole situation. For the simple courtesy to the patient. That said, I would say the man himself is vulnerable and people (relatives) in this state are in a highly suggestible frame of mind and react to situations they wouldn't normally react to. I would caution the OP in continuing a relationship but it seems to me that is unlikely to stop - so the only course of action which remains feasible professionally is for her to be removed from the team caring for the patient. I think citing a conscientious objection that the patient and family have become attached to her is a reasonable grounds for being assigned another case. Link to post Share on other sites
Walking away Posted July 22, 2008 Share Posted July 22, 2008 Excuse me????? Did you really just say that? I am not a nurse but even I KNOW THAT is not true. PLEASE read up on depression and disability. is brain function. People that are depressed can still think and talk. Link to post Share on other sites
Lookingforward Posted July 22, 2008 Share Posted July 22, 2008 It's not her responsibility to explain it to the wife. That is the responsibility of the medical agency. Yes, it probably would be common courtesy to explain it - but like I said previously citing that there is an emotional attachment to the patient AND the family is more than enough of an excuse to remove oneself from this situation. There does not need to be a technical, fancy medical reason. If I'm attached to my patient, or the family, I'm not functioning at an appropriate professional level. Period. That's the top and bottom of any kind of discussion needs to take place. But IMHO it isn't the place of the nurse to have that discussion. It's the place of the employing agent. I totally agree...she is a professional and professionals can and are replaced..... Link to post Share on other sites
luvmy2ns Posted July 22, 2008 Share Posted July 22, 2008 I hope to hell that somewhere down the road if I have an accident and am stuck trapped with a fully functioning brain in a paralysed body that my carers don't take the attitude that I'm just a vegetable........thank you very much. I know, huh?! It's like when I had this two day course in triage and first aid. This "woman" in the class raised her hand, after we had learned CPR (again) and asked, "Now that I have this card, if I see someone who isn't breathing do I HAVE to do CPR? What if they're, like, someone who looks dirty?" I said, "Man, I sure hope my hair and makeup are done up nice if I pass out in front of you." Link to post Share on other sites
Tomcat33 Posted July 22, 2008 Share Posted July 22, 2008 I didn't know that the patient was elderly, late in her life, or suffered a stroke. But does depression affect congitive function or not? Link to post Share on other sites
Walking away Posted July 22, 2008 Share Posted July 22, 2008 Depends on her medical condition, cause of disease process, age, and other factors which I have no knowledge of, as HIPPA requires confidentiality in this situation. I am intelligent enough to know that every person varies. And to assume that I know her level of depression is ludacrious. Christopher Reeve didn't looked depressed to me, but what the H do I know? I wasn't his caregiver. Neither were you. So to ASSUME that he was because he was a quad is quite a stretch and quite generalized. Joni Erikson Tada has a vibrant life and she is a quad. I can name many. And I am quite certain that they would cringe if they were referred as a vegetable. In this case, from what I've read, it sure sounds to me like this patient is quite alert and it isn't for you or I to judge her mental status. WE AREN'T THERE. I am also intelligent enough the bow out of an antagonistic conversation. Link to post Share on other sites
Tomcat33 Posted July 22, 2008 Share Posted July 22, 2008 Depends on her medical condition, cause of disease process, age, and other factors which I have no knowledge of, as HIPPA requires confidentiality in this situation. OOOOOHHH ok that's a different story than "depression has NO effect on cognitive abilities" glad you understand now. one more and in fact this one is prob closer to the OP W http://www.ncbi.nlm.nih.gov/pubmed/18484237?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum Link to post Share on other sites
Walking away Posted July 22, 2008 Share Posted July 22, 2008 OOOOOHHH ok that's a different story than "depression has NO effect on cognitive abilities" glad you understand now. one more and in fact this one is prob closer to the OP W http://www.ncbi.nlm.nih.gov/pubmed/18484237?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum She has MS? You should have told me that? I have LOTS of experience with that! You are referring to this correlation in regards to certain medical conditions: NONE of which have been addressed by the OP. So to assume anything is wrong. WA Link to post Share on other sites
Lookingforward Posted July 22, 2008 Share Posted July 22, 2008 While certain mental conditions such as depression MAY affect the reasoning abilities they do not however impair the ability to take IN information and process it - which is what cognitive functioning IS Link to post Share on other sites
Lookingforward Posted July 22, 2008 Share Posted July 22, 2008 She has MS? You should have told me that? I have LOTS of experience with that! You are referring to this correlation in regards to certain medical conditions: NONE of which have been addressed by the OP. So to assume anything is wrong. WA we haven't been told whether this state was due to accident or illness...... unless I missed a post somewhere Link to post Share on other sites
luvmy2ns Posted July 22, 2008 Share Posted July 22, 2008 While certain mental conditions such as depression MAY affect the reasoning abilities they do not however impair the ability to take IN information and process it - which is what cognitive functioning IS I think that is the point WA is trying to make. You summed that up nicely. Link to post Share on other sites
Walking away Posted July 22, 2008 Share Posted July 22, 2008 While certain mental conditions such as depression MAY affect the reasoning abilities they do not however impair the ability to take IN information and process it - which is what cognitive functioning IS Thank you for understanding. Link to post Share on other sites
Walking away Posted July 22, 2008 Share Posted July 22, 2008 we haven't been told whether this state was due to accident or illness...... unless I missed a post somewhere That is my point. She is pulling up posts about specific medical conditions, which may not pertain to this patient. None of these conditions have been revealed in THIS PARTICULAR PATIENT. You can't make a blanket statement about what she is trying to make a point about without the proper knowledge of the patient's condition. Link to post Share on other sites
Walking away Posted July 22, 2008 Share Posted July 22, 2008 I hope to hell that somewhere down the road if I have an accident and am stuck trapped with a fully functioning brain in a paralysed body that my carers don't take the attitude that I'm just a vegetable........thank you very much. I wouldn't. Ever. Link to post Share on other sites
Walking away Posted July 22, 2008 Share Posted July 22, 2008 No, (not that I know of) she has the same debilitating symptoms as MS (paralysis) and I would assume depression that accompanies that. Which is why I introduced the idea of depression and congnitive disfunction it was a natural leap for me. Hope your knowledge of MS is better than that of depression. ;) I know little about depression. I am a heart nurse. You need your heart fixed, I'm there. The mind....I just care for it the best way I know how....with love and compassion... Link to post Share on other sites
luvmy2ns Posted July 22, 2008 Share Posted July 22, 2008 I know little about depression. I am a heart nurse. You need your heart fixed, I'm there. The mind....I just care for it the best way I know how....with love and compassion... And, I trust, WITHOUT making assumptions such as are being made in this quest to be right. Link to post Share on other sites
Walking away Posted July 22, 2008 Share Posted July 22, 2008 I am suprised if you have lots of experience with MS you didn't now about depression vs cognitive function!?!? sorry meant to add this to my last post but didn't give me time... I have a friend with advanced MS and cognitively she is intact. She suffers from depression and is treated for that. But, she is fully functioning in the brain even though her body is shutting down. And she is end stage. She may talk slow, she may be depressed, but believe me, she is ALL there upstairs. Link to post Share on other sites
Tomcat33 Posted July 22, 2008 Share Posted July 22, 2008 I have a friend with advanced MS and cognitively she is intact. She suffers from depression and is treated for that. But, she is fully functioning in the brain even though her body is shutting down. And she is end stage. She may talk slow, she may be depressed, but believe me, she is ALL there upstairs. I know hun my dad had Cancer but I wouldn't pretend to know all the ins and outs about the disease because of my little experience. BUT I can at least see where you were coming from... Link to post Share on other sites
Walking away Posted July 22, 2008 Share Posted July 22, 2008 I know hun my dad had Cancer but I wouldn't pretend to know all the ins and outs about the disease because of my little experience. BUT I can at least see where you were coming from... I just know that I am not ALL KNOWING ABOUT ALL THINGS. And even though you are right, in some instances, you are wrong in others. I do know that we don't have near the information to jump to the conclusions about this patient, which you have done. I am simply defending the defenseless.....the wife. Link to post Share on other sites
Lookingforward Posted July 22, 2008 Share Posted July 22, 2008 I had actually forgotten that Chris Reeves was also a "ventilated quadraplegic" and hardly a vegetable and I think he would have definitely known if his W had been romantically involved with one of his caregivers (just a thought) Link to post Share on other sites
luvmy2ns Posted July 22, 2008 Share Posted July 22, 2008 I just know that I am not ALL KNOWING ABOUT ALL THINGS. And even though you are right, in some instances, you are wrong in others. I do know that we don't have near the information to jump to the conclusions about this patient, which you have done. I am simply defending the defenseless.....the wife. I know one thing for sure. You and Chinook and the OP know more about this than anyone else on this thread thus far since you are trained medical professionals. If anyone else claims to know more, they are just being childish and foolish. Link to post Share on other sites
Chinook Posted July 22, 2008 Share Posted July 22, 2008 I had actually forgotten that Chris Reeves was also a "ventilated quadraplegic" and hardly a vegetable and I think he would have definitely known if his W had been romantically involved with one of his caregivers (just a thought)Actually I read Chris Reeve's book and he was seriously depressed and contemplated suicide many times. But he was very, very aware of everything going on around him. His book 'Still Me' is a fantastic read and very emotionally draining, even for a reader. Link to post Share on other sites
Tomcat33 Posted July 22, 2008 Share Posted July 22, 2008 You were generalizing. No I think I was being pretty specific. But in terms of whether this woman is depressed or not I was speculating yes indeed I was, just as you are speculating that she can sense the romance. See we can both speculate. Link to post Share on other sites
luvmy2ns Posted July 22, 2008 Share Posted July 22, 2008 Actually I read Chris Reeve's book and he was seriously depressed and contemplated suicide many times. But he was very, very aware of everything going on around him. His book 'Still Me' is a fantastic read and very emotionally draining, even for a reader. So, in other words, being depressed doesn't lead to one being unable to comprehend and be "cognizant" then. Kinda what WA was trying to say. Link to post Share on other sites
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