Question

A 48-year-old woman is admitted to a psychiatric inpatient unit for observation and evaluation after an episode in which she murdered her husband of 22 years, a well-renowned legislator, after finding out that he had been having an affair with his 23-year-old political assistant. The case has received tremendous media coverage.

Upon admission, the patient expresses both suicidal idealization as well as homicidal idealization with a plan to kill her husband’s young lover. She also reveals that her husband had been unfaithful once before, early in their marriage. When documenting the assessment, the RN includes that the patient expresses both suicidal and homicidal idealization with a specific plan toward the 23-year-old political assistant.

Should the information about the husband’s past infidelity also be included in the assessment note? Explain your answer.

Should the RN notify others of the patient’s homicidal thoughts and specific plan for the political assistant with whom the patient’s husband had an affair?

Answer 1

Answer: ◆ Yes RN should add the information about the husband's past infidelity in the assessment notes because...

1. First of all patient's past history is very important to know the exact condition of the patient as past life events directly affects to the patient future activities and disease. It is the main part of patient's history collection.

​​​​​​​​​​2. Patient is admitted to the hospital for her psychiatric problems and these psychiatric problems can be result of the husband-wife personal disputes.

3. Personal disputes can lead to a stressful or depressed or aggressive thoughts of a person that also can be the cause of patient's psychiatric problems.

4. Dishonesty of the husband also can be very shock able event for the patient that also can be the cause of her psychiatric problems.

5. Lack of interpersonal relationship between husband and wife due to husband's infidelity also can be the cause of patient's psychiatric problems as she was unable to share her feelings with her husband.

◆ Yes RN should notify others of the patient's homicidal thoughts and specific plan for the political assistant with whom the patient’s husband had an affair because...

1. Notifying the patient's thoughts and plans is very important part of history collection under subjective data (patient self statement about his or her problems thoughts and plans).

2. Notification of information about patient's homicidal thoughts can be very helpful to know about patient's mental and thinking status in order to observe and evaluate her successfully.

3. It also can be very helpful to know the exact state of mind of the patient like that aggressiveness, cruelity etc.

4. As patient is admitted for observation and evaluation in that case the information about patient's thoughts and plans can be very helpful to monitor her and to evaluate her in a good manner.

5. If we will have enough information about patient's thoughts and plans that will be very helpful ventilate her feelings and to evaluate her in a well organized manner with enough information.