Postpartum Psychosis Case

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Hi everyone.
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Welcome to another episode of Tattoos and TeleL.
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We are going to chat it up today regarding a couple different things, but the first thing we're going to talk about is this case that is currently open and public about the mother who murdered her three children and then tried to kill herself.
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And Kelly and I were just talking about that.
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We were just chatting it up and so I thought she's okay, let's just hit record because we're just now speaking of this together.
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And I want to preface this with saying that neither neither Nicole nor I have any political stance here.
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Okay.
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This is not going to be a political conversation.
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This is not going to be a one side versus the other side.
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He said, she said.
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That's not what this is about.
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These are two nurse practitioners who have been bedside nurses who stand beside a nurse that understands the back and forth of charting.
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That's kind of where I want to go with this, in that this case was what we were just talking about before we hit record, has been very much about the documentation.
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And that's kind of where I want to hit this.
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The documentation of these healthcare providers, from the psychiatrist to the bedside nurse to everyone that was involved in this poor woman's care from beginning to end.
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This is why we are taught as nurses, Nicole, and I know you were too, that if you don't document it, it didn't happen.
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But if you over-document it, it happened.
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And little words like that, one of those psychiatrists that got put up there, that attorney tore her apart because she missed a comma, or she put a comma before a word.
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Or how would you interpret that?
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They completely ripped her.
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I had another colleague screenshot part of that testimony and sent it to me.
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She goes, Can you believe it?
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I'm like, Yeah, yeah, I can because that's what we were taught.
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You chart it, it happened.
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And then some you don't chart it, it didn't happen.
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Yeah.
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In God we trust, everyone else must chart.
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Yes.
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So I felt like one of them in one of the questionings, he was attacking her, questioning her about checking the boxes.
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And I feel like I was waiting for her to say, look, I don't make the rules, okay?
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I didn't make the EMR.
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Okay.
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I just do what I'm freaking told.
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Okay.
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I'm given the tools that I'm given.
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You can't take a car to a mechanic if they have limited tools and they can't do the job 100%.
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But that's the tools you have.
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Sometimes you gotta make do with the tools you have.
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If you're working in a rural area, if you are working at an in an underserved community, if you are working in the high end in the middle of Martha's Vineyard, it that's gonna be well funded.
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Things are gonna be different.
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So I'm just saying that this girl, she was he was like, So, do you just check the box?
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It's unfortunate, but I feel like sometimes, especially if not at the bedside, I went to school, and there's more to it, and I'm halfway being sarcastic, but I went to school to fucking check boxes.
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Yes.
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Yes.
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And I'm gonna add to that in that, especially in these situations, here's what people may or may not understand that I want someone to take away from this conversation is that this is what nursing has come down to.
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We do not get to care for patients.
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And I'm gonna get a little aggressive here when I say this.
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This is almost like I feel like teachers have to teach for the test.
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We have to chart for the test.
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We are required to sit down and check all these little boxes instead of actually being able to take care of the human.
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You heard her say, you heard someone say, we have these tests that we go through and we have to check.
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Do they have this?
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They have the we have these questionnaires, we have this, we have questionnaire this and questionnaire that.
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This is the problem.
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We questionnaire people to death.
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There's questionnaires for dementia, there's questionnaires for ADHD, there's questionnaires for depression, there's questionnaires for anxiety.
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We questionnaire people to death.
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And if you don't pick the right questionnaire that gave you the right answers, do you get the right diagnosis?
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If you don't, if you don't pick the right questionnaire, do you get the correct diagnosis?
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And so then now we're down to this discrepancy on the stand of the interpretation of this.
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Well, did she have pressured speech?
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Um no, no, no.
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You cannot force someone to make up an emotion on a checkbox questionnaire.
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You can't, and I feel like that's what this was, that's what they were trying to do.
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They were pushing her into testifying on her feelings for a checkbox questionnaire based on how she felt about the speech she was portraying when she filled out the questionnaire.
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It was first of all, it's unrealistic.
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Correct.
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One, this whole thing is unrealistic.
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Yes, this whole thing they cannot prove a jury or a judge or whoever, in my opinion, cannot prove would have a difficult time proving unless there's some trickery going on, to be fair, in my opinion, that if she had psychosis three years ago, you can't Monday morning quarterback that.
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You can't.
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This is not a case of let's see if she is has the mental capacity to stand trial now.
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No, that's not the case.
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They know she did the crime.
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Yeah, no, nobody's denying that.
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She's not there trying to say, right, did she have mental capacity to know better then?
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No.
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How can you determine that?
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There's no way, without a shadow of a doubt, you can determine what she was thinking at that time.
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There's just no way.
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There's just no way.
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And the fact that her husband, her ex-husband, and her nanny are like she was amazing.
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She went to school to work with babies.
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I just think this is I don't know.
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Honestly, it makes me sick.
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And I think that we're gonna go through all of this, and she's by the grace of God, she'll be found not guilty.
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Yeah.
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I think what this also due to acute psychosis.
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Yeah, yeah, for sure.
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And I do hope that I hope there's a couple of takeaways here.
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One, I hope that this significantly boosts the funding for mental health providers, for there to be some more funding, training, and education in that space, because I think that it is incredibly lacking.
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I think that postpartum psychosis goes underdiagnosed.
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I personally have witnessed it.
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I have seen, I had a patient who took her newborn into a bar.
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Her newborn baby.
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She just up and went and met her friends at a bar and took her newborn in there and sat it down, was having drinks with her friend.
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It didn't clue into her mind that was inappropriate until the bartender had to walk over and go, You can't do that.
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You have to leave.
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And when she got out to her car, she called me bawling because she didn't realize what she was doing.
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Let's be real.
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People that make those decisions and people that hurt their children are not mentally okay.
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Period.
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Yes.
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Period.
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And this was back when I was working in women's health.
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And so I'm gonna tell I'm gonna I'm gonna preface this with these things happen.
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It is not okay.
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And being able to recognize when things like this happen can be very difficult.
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And so that's the one thing I hope comes of this is that we as a society see that there needs to be more funding for mental health, education, providers, positions, paid, like these provide.
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There needs to be something to fix this.
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This is a broken system.
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That's number one.
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Number two, I hope that this opens the eyes of some nurses when it comes to their charting because we're seeing two sides.
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We're seeing some incredible charting.
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That ICU nurse, man, her charting was spot on.
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Kudos to her job was to advocate for the patient.
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Yes, and she did it very well.
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She was very matter-of-fact.
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There was a psychologist that was up there, and I can't remember which one it was.
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And I was like, What is going on here?
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Did the attorney prep her for this at all?
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Yeah.
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What just answer the question?
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Just the question.
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Yep.
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Just the question.
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Was this okay?
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Absolutely not.
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What this mother did was absolutely not okay.
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But any mother that does such is not okay.
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They are not in a healthy space.
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And we know that because she sought help, she tried meds, she switched meds.
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That alone, switching meds, if it's not the right perfect way for that patient, can cause psychosis.
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Stopping a medication can cause psychosis.
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Starting a medication that doesn't do well with you can cause psychosis.
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There's no way to prove, and we'll probably pick this back up when the case is over.
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There's no way to prove what was in her mental state three years ago when this happened.
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And if anyone thinks that anyone that was can be in their right state of mind and do this, they have mental health issues.
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Do they need to be punished?
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That's for the court to determine.
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Because there's different levels of mental capacity.
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Yeah.
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But in this case, she was clearly, and there's evidence of acute psychosis.
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There are signs that was impending.
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And I think I think the system failed her in many ways.
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Many parts of the system failed her.
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I'm not saying that any one person failed her.
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I think the system as a whole failed her.
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I think we as a society can do better.
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I think we as a healthcare society could have and should have done better.
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And I also think that, and this is my personal opinion, sometimes as nurses, we do this with our families, right?
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If you're not dying, you're fine, go away.
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Right?
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We let our kids, our spouses get sicker than a dog before we finally go, okay, fine, here's some antibiotics.
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But I think that sometimes there's a stigma to ourselves too.
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And to other nurses, we think, well, she's a nurse, she'll be fine, she knows how to deal with it.
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That's not an okay answer.
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If you wouldn't treat your patient that way, don't treat your fellow nurse that way.
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Sometimes I don't like to tell people that I'm in medicine because I want the same treatment.
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I want the same treatment.
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I want the same treatment as somebody who knows nothing about this disease.
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Yes, because I think that sometimes we do the same thing to each other.
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We think, oh, she's a nurse, she knows how to take care of herself.
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No, no, you don't.
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Because when it's you, when it comes to you, the blinders are on.
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The blinders are on.
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When it's your family member, the blinders are on.
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And it's there's some people that may disagree with me there, and that's okay, you can, but I've from personal experience from and Nicole can attest to this from trying to help treat my own spouse who is a cancer patient, my daddy who's a cancer patient, trying to help like the blinders are on.
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And that is not okay.
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And so I wonder if some of that wasn't because she was a nurse, that there was some of this, she's a nurse, she knows how to deal with it.
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She'll be okay.
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Yeah, or if she really needs help, she'll call or whatever.
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Yes, she knows what to do.
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Don't take that for granted.
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Because if you're in the right space, you're not in the right space.
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And if you're not in nurse mode, yeah, you're just not in that.
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But you can't nurse yourself.
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Sometimes in our families, like you were saying, unless your head is down, your feet are up, and you got and we're ready to put some breathing tubes in, you're fine.
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Okay.
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And that's that's that's slang.
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It's right, it's a stretch.
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But on the other hand, if something happens and we see it as a red flag, we are like, okay, I know too much.
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You got to go to the ER.
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I know this is seems simple to you, but this is nope, this got to go to the ER.
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And they're like, I just bumped my head or whatever.
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I don't care.
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I don't like the way this whatever looks.
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Nope, going to the ER.
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And other things, they're just like, okay, I don't feel good.
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I'm like, well, you're fine.
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Yeah.
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Yeah, exactly.
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Exactly.
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And so I do hope that's some things that we see change.
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I hope we see some policy change come from things like this.
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I don't know that we will, but I hope we do.
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I hope we see some policy change.
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Those poor babies, those poor babies, truly.
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And she's, if people think she hasn't already beat herself up enough.
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Oh my gosh, can you imagine?
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I cannot, and I'm saying this, I'm saying this as a mom.
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I cannot imagine how she must be feeling once she came out of that psychosis, once she came to the reality of what she was going through, what she went through, what she did, what she has to admit she did, and now how the world feels about her.
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I cannot.
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I just cannot.
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And she has to live with that.
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Yeah, I cannot.
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The outcome is regardless of her education or career status.
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Yeah.
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Any mother that would do that, it was clearly not in their right mind.
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That's for today.
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Alright, guys.
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Stay tuned, and I'm gonna keep watching the trial.
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And we'll we'll probably come back and talk about this some more, but the those are just well, those are just some things we want you guys to think about.
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So anyway, take care, guys.
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Love each other.
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Bye.