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PBH 305 Scenario Assignment

Jane works as a nurse in Dr. Ford’s family primary care office in the same small town that she grew up in. Jane sees many patients that she knows from around town, or patients with whose parents are childhood friends. One day, Hailey, an 8-year-old patient, comes in for her annual checkup.

Hailey’s mother, Jessica, is an old friend of Jane’s from school.  As Jane is taking Hailey’s blood pressure, she notices circular bruises that go most of the way around Hailey’s arm.  When she acts concerned, Jessica immediately laughs and says “Oh, this girl is always so clumsy, falling over and hurting herself! She always has bruises!”  Jane also notices that Hailey is withdrawn and always looks to her mother before answering any questions.  When Jane checks her growth charts, she sees that Hailey has not gained much weight since last year, and her percentile for weight has gone down.  Jane shares her concerns with Jessica about Hailey’s growth, and she agrees to look at her diet and add more healthy protein and calories to her daily intake.  Jane feels uneasy about this situation, and mentions this to Dr. Ford three days later, when they have a minute to talk.  Dr. Ford says that she understands Jane’s concern, but that she has been seeing Hailey’s family for 10 years and that she’s sure everything is fine.  Feeling relieved, Jane reminds herself that Jessica is a wonderful, kind person would never do something that would hurt anyone.  Two weeks later, Jane is at the local grocery store and turns into an aisle to see Jessica yelling at her elderly mother-in-law, with whom she lives.  Before they notice Jane, Jessica grabs her mother-in-law’s arm and pull her, hard, towards the cart.  Jessica’s mother-in-law falls to the ground.  Jane rushes over to the elderly woman, stating “I am a nurse, let me check you out.”  After looking her over, Jane recommends that Jessica bring her to the Emergency Department for a possible broken wrist.  Jessica, not realizing that Jane saw the whole interaction, thanks her profusely and takes her mother-in-law to the car, promising that she will take her to seek medical treatment.

  • Please read the scenario carefully and discuss any potentially abusive situations, and who might be responsible.
  • Please discuss who, if anyone, had a responsibility to report an abusive situation in this case.
    • Did they meet that responsibility?
    • What information needed to be reported?
    • To whom should this information have been reported?

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