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Emma Jackson, a 1-year widow who lost her job 3 months ago, has spent 2 days in a row, from morning till time to pick up her kids at the school bus stop, waiting in an emergency department to get help for what appears to be severe depression. Now, at the end of this second day sitting in the waiting area, she approaches the admitting nurses’ station in tears and says, “I don’t know how much longer I can take this. Don’t you recognize me?” “No, ma’am, I’m sorry,” the nurse says. “Offhand, I don’t.” “Well,” says Emma, “I’ve come in here 2 days in a row. I need help, and I can’t get in to see anybody because I’m not bleeding to death, but I’m desperate! I’ve spent the last 2 weeks, until yesterday, in bed. And yet I can’t sleep. Do you know how many days I’ve been without sleep? I’m so exhausted and so depressed I’m tempted to shake my kids for the least little thing, and I now have zero tolerance for careless drivers and sometimes I just want to drive straight into them to teach them a lesson, and that’s not like me. My kids are becoming my only reason for going on, and that’s not good for them. I think they can see it, and it scares them. They’re trying to be super-good …” Thinking of how her despair is affecting her children, Emma bursts into uncontrollable sobs. 1. The psychiatric nurse takes Emma into an examining room immediately to interview her. Based only on what you’ve just read, what in your opinion is the likelihood of Emma being admitted for short-term inpatient care? Give at least two admission criteria that may apply to her situation. Offer (a) a possible causative factor and (b) symptomatic evidence.
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