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 do you do? You have been sworn to secrecy, but should you break the confidence to protect Rachel?
Do you agree with the proposal below?
NOTE 1: If this is the first time you have used the Think Screen please 1) do not use all the wedges and tiles - just the ones that help you express your opinion and 2) write as much free text as you can.
NOTE 2: You will be asked some detailed questions about your professional role and choices in a follow-up survey to this Think Screen.
It is proposed that you tell a member of the care team about Rachel's intention to commit suicide