夜班:自殺意識形容

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“Not其他自殺患者,“負責護士呻吟著作為一個14歲注冊的首發投訴,因為屏幕上彈出了。我們在我們醫院沒有精神科服務,我們認為自己很幸運能夠在12小時內進行分歧患者。除了在完成和傳真集記錄到三到四個設施之外,還涉及護士20-30個電話呼叫。

我試圖在自殺患者上采取一些不同的展望,特別是在患者之後,我在多年前仍然記得很生動。這個故事開始與一個不太適合的初中生開始。她似乎很好。她似乎很開心。她試圖和人相處。但她的同學會不斷挑逗和欺負她。她不確定為什麼。“卑鄙的孩子”會在走廊裏恐嚇她。


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她有一個充滿筆記的盒子,惡霸會在她的儲物櫃裏留下,告訴她她“毫無價值”,沒有人喜歡她。她試圖為POMS團隊試圖,是唯一一個被切割的人。它達到了學校午餐室的觀點變得如此壓力,以至於她過去常常在浴室的一個攤位中吃午餐。

She thought about committing suicide. Her mother brought her to the emergency department at one point. I didn’t think she was truly suicidal, she just appeared desperate. I encouraged her not to let these bullies get in her head. By reacting to their taunts, she was only giving them power. Instead of being hospitalized, she was referred for counseling.

不幸的是,欺淩對年輕女孩的心靈做了很多傷害。然後上帝派了一個天使進行幹預。其中一位老師有一天看到女孩哭泣。在了解了年輕女孩的問題之後,她給了這個女孩一個大廳通行證,所以她每天都可以和老師一起吃午飯。老師為學生提供了一點孤獨,學生需要通過上學日。


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慢慢地,這位年輕的女孩對她無法忽視欺淩的觀點感到自信。她在高中嚐試過運動,並製作了賽道團隊。她的高年級,她是足球比賽的PEP集會的兩位領導者之一。她繼續大學,是她宿舍的總統一年,畢業於商業學位。她最頑強的惡霸之一最終被禁止吸毒,另一個人從學校掉了出來,生活在父母的地下室。我知道這一切,因為我仍然偶爾將她視為患者,我仍然從她和她的母親那裏得到卡片。很高興知道有時有時的建議可能會有所不同。

The overweight suicidal 14-year-old boy was a similar story. He was a lineman on the junior high school football team. Because of his weight, he was also the butt of his teammates’ jokes. When he entered the lunchroom, teammates would yell “Hide your lunch, Devin’s coming!” If he missed a block during a game, teammates would tell them that he probably wouldn’t have missed the block if he “wasn’t so fat.” He was seeing a counselor, but counseling wasn’t enough to overcome the constant taunting. The final straw came when a family member died and Devin left school early on Thursday to go to the funeral.

他的一位同學們在課堂上喊出“他隻是早點,所以他可以在其他人到達那裏之前獲得免費食物。”整個班笑了。他感到羞辱。他星期五不想上學,但他的父親告訴他他別無選擇。在絕望時,他發現了他的一些祖母的膽固醇藥,並在自殺的嚐試中占據了一些藥片。然後他告訴他的母親他所做的事。她叫救護車,但到救護車正在播落的時候,她決定將她的兒子帶到急診部門。

We watched as the triage nurse led him to the designated psych room. He trudged slowly down the hallway with his head hung low. When I spoke to him and his mother, he was calm, but obviously depressed. He didn’t feel suicidal, but just wanted a long weekend away from school so people might forget about what had happened to him in class the day before. Tears streamed down his face.


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The emergency department was busy, but I took a few extra minutes to just sit down and talk with him. I gave him the same advice that I gave to that other junior high student many years ago. You can’t let these dummies get into your head. If they don’t get a reaction from you, eventually they will leave you alone.

Find someone you trust and can confide in whether it is a teacher, coach, a pastor or another classmate. Don’t go through this alone. Your parents will always be there for you – don’t be afraid to talk to them. You將要贏過了這個和你將要比那些惡霸更好。你有很多期待在生活中。我不確定我的小Pep談論是否有很多幫助,但至少他似乎聽到了。

I left the room to go see another patient as we waited for a social worker evaluation. While I was reviewing the next patient’s medical history, I got a text message from my oldest daughter. “When you have a second to breathe, give me a call!”

我最古老的女兒是在她的第二年的法學院,並且在她的第一個學期開始有點艱難時,令人驚訝的是。她也是我們四個孩子中最重要的。她喜歡從事隨機善意的行為,讓別人的日子變得更好。

例如,我有一次注意到垃圾中的星巴克收據,表明她早上買了2杯咖啡。我問她另一杯誰。

She said that the line at the drive-up window was longer than usual that day. In her rear-view mirror, she watched the person in the car behind her become frustrated, yelling, waving his hands, and banging on his steering wheel. She laughed a little bit, but then thought she would “brighten his day,” so she paid for his cup of coffee before driving off. I don’t know what I did to raise such an awesome kid.

I called her to find out the good news. She was chosen to be a judge for an upcoming seminar for the first-year law students. Only a few students got that honor.

“Congratulations, honey. I’m proud of you.”

“What’s wrong,” she asked, “I can hear it in your voice. Did someone die?”

“不,隻是一個被欺負的初級高級學生,誰進入抑鬱症。看看這些孩子有時會有多大意思讓我感到難過。“

“哦......爸爸。”

“現在不能談論它,親愛的。這很忙。恭喜你的榮譽。明天我回家的時候會見到你。愛你。”

我從看到下一個病人來回回來,我的手機上還有另一個文字。它來自我的女兒。

“現在你讓我哭了。我剛開始反映我真正來的距離。請告訴您的患者不屈服於惡霸!他們可能在他身上看到了他們知道他們沒有自己,嫉妒。你必須穿過一些山穀,然後才能到達山頂,你可以觸摸星星。“

我拍了一條短信的屏幕截圖,打印出來,並將其送給德文。他給了我一點微笑,折疊了紙張,用衣服把它放在角落裏。

社會工作者來評估他並清除他卸貨。

我回到了房間,以確保Devin是可以的,他和他的母親沒有任何疑問。他的母親告訴我“我拍了你女兒的信息。我現在要把它發短信給我,然後這樣,他不會失去希望。“

Then I decided to take a few more minutes to tell them about that patient from long ago who was relentlessly bullied in junior high school in the same way he was being bullied now. I told him how she found a teacher that helped her work through it. I told him how she went on to do well in high school, did better in college, and how she just got elected to be a judge in an upcoming seminar for first year law students at her law school.

患者和他的母親都感謝我,但這次訪問的最佳部分是在他的臉上帶著微笑看著德文隊走出急診室,他的頭腦很高。

沒有太多的職業,讓你這樣觸摸某人的生活。

The “proud papa” bit is just icing on the cake.

關於作者

SENIOR EDITOR DR. SULLIVAN, an emergency physician and clinical assistant professor at Midwestern University in Illinois, is EPM’s resident legal expert. As a health law attorney, Dr. Sullivan represents medical providers and has published many articles on legal issues in medicine. He is a past president of the Illinois College of Emergency Physicians and a past chair and current member of the American College of Emergency Physicians’ Medical Legal Committee. He can be reached at his legal web sitehttp://sullivanlegal.us.

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