PPE ASSESSMENT QUESTION 2: RACHEL'S PLEA

You are working at City Hospital where you have been involved in the care of Rachel (24) for the past 6 weeks. Rachel has had a double below knee leg amputation following a car accident, and as a result also has severe facial disfigurement, as well as several fractures to her pelvis.

Rachel was an accomplished athlete and holder of several national records in a number of middle distance events. She had been driving to a qualifying event for the next Commonwealth Games team when her car was involved in a collision with another vehicle. Apart from her sporting successes you have found you have a lot in common with Rachel and she will talk to you openly. In the past 2 weeks, you have noticed a distinct decline in Rachel’s mood. Rachel is irritable, and her optimism for the future has disappeared. Rachel is unmotivated in her recovery and is no longer making any progress.

Rachel swears you to secrecy and confides to you that she cannot imagine life outside of the hospital with her lost limbs and facial disfigurement, and that she has come to the conclusion that her life is completely ruined. Rachel tells you that she is saving her medication for the right time to commit suicide. You try to convince Rachel to have counselling but Rachel gets angry and says she won't talk to you any more, and will sort out her own problem.

What should you do?

Remember that this Case will be submitted for grading according to Learning Outcome 1, so please ensure you have responded in depth and with thoughtfulness, with your response reflecting an understanding of the ethical tensions involved in confidentiality issues. Also note, that unlike earlier Vx Practice Cases, in fairness to all students, submitted Cases will not be re-opened, so please ensure you see that the 'Saving' icon at bottom right of screen has been activated (this is achieved by moving to a different screen - you will see the Saving message appear), then it is safe to exit or submit your work.