Bea Yorker
Appearances
Nobody Should Believe Me
Revisiting Season 3: Shelter
I'm a nurse. I am a mandated reporter. I am required to report suspected abuse. I am not required to verify abuse. That's the job of CPS, Child Protective Services, or law enforcement. As a mandated reporter, I have immunity for reporting if it's done in good faith, if I happen to make an error and it wasn't abuse. On the other hand, to diagnose someone with a DSM-1,
Nobody Should Believe Me
Revisiting Season 3: Shelter
or an ICD-10 or 11 diagnosis, I would need to be a physician, a psychiatrist, a PhD psychologist, or somebody within whose scope of practice it is to diagnose. As an advanced practice nurse, it's my scope of practice to do nursing diagnoses. But believe me, Factitious disorder imposed on another is not in the book of nursing diagnoses. So I always say to the court, I am a mandated reporter.
Nobody Should Believe Me
Revisiting Season 3: Shelter
I am qualified to identify and to confirm because of my advanced practice training. I am qualified to confirm whether abuse has occurred to this child or neglect or sex abuse or, That I am qualified to do. What I am not qualified to do is to diagnose why the perpetrator is doing it. And so I defer. I say, yes, in this case, the child is being medically abused and over-medicalized.
Nobody Should Believe Me
Revisiting Season 3: Shelter
And the mother is fabricating and exaggerating. And it's up to somebody else, hopefully, who understands that the record review that I performed... is the most illuminating for diagnosing factitious disorder imposed on another and looking for fabrication. But sometimes they need to determine, is it malingering? Is it anxiety? Is it delusion? Is it factitious disorder imposed on another?
Nobody Should Believe Me
Revisiting Season 3: Shelter
And FDIA should only be diagnosed when you both interview the suspected perpetrator and review the medical records for fabrications.