Faking it? How to tell?

NutmeggeRN, BSN · May 9, 2012

Kids-faking? for real!? :eek:

Yes and no....when a kid is sick, it usually pretty evident, they truly get green/gray around the gills...they look like hell!

:barf01:

I can usually tell when they have a migraine- there is alook in there eyes that is just not focused (often they are photosensitive).....a malingerer will have no temp, is not flushed, no rackng chills, throat is not puffy or red or full of exudate....

Tummy aches are a little more difficult, one nurse on another thread will check bowel sounds! very loud and gurgly when they are not feeling well, pretty quiet if they are OK.

Although it seems sometimes the throats that look A-OK end up culturing + for strep and the ones that look like hell dont!

Quite often your gut will tell you whether or not they rally are ill, a I ALWAYS get a temp and o2 Sat with any respiratory issue.

Hope this helps!

Double-Helix, BSN, RN · May 9, 2012

I just read this article on AN yesterday. Maybe you'll find it helpful. :)

https://allnurses.com/school-nursing/how-fake-sick-706282.html

sauconyrunner · May 10, 2012

Kids are often little Drama Kings and Queens. But I would not rely on any sort of "rule of thumb" regarding fakers. I always assess each kid really thoroughly. In that time I can usually decided if they are just kind of fooling around or overreacting to their own symptoms. Kids who are extremely quiet and extremely cooperative with everything tend to get my alarm bells ringing.

CloudySue · May 10, 2012

I agree, the ones who never complain and are there with something are the ones you should always take seriously. When I was pregnant, I sucked it up when I had the usual symptoms and didn't bother my OB/GYN. When I had a problem near the end and I called the doctor, they immediately sent me over to the hospital saying, "You never call to complain about anything. So if you are calling us now with this, we know something's up that needs to be checked out." It's those who cry 'wolf' all the time that put themselves in potential danger if something real were to happen.

CampNurse1 · May 16, 2012

Even when a camper is "faking" it, they still require a nursing intervention, usually for anxiety. I work at a special needs camp, and I see a good bit of maladaptive behavior. My favorite are the "fake" seizure. Be sure and call out a campers name or clap your hands during a seizure. If they turn towards you, bingo! I think it is important to not get upset about these behaviors; there is a reason for it! These behaviors often work for them at home and school. I make a behavioral contract with the camper. "I think you are having too many headaches to go to the dance tonight." Something like that.

Do not let the first impression of malingering keep you from making a good assessment. EVERYTHING requires an appropriate inervention, "real" or not.

Alex Egan, LPN, EMT-B · May 17, 2012

Fake unconscious? Pick up their hand and hold it in the air over their face. Let it go. If they are faking they won't hit themselves in the face, it's hilarious watching their arm suddenly and magically divert from their face.

LittleWing21, RN · May 19, 2012

Fake unconscious? Pick up their hand and hold it in the air over their face. Let it go. If they are faking they won't hit themselves in the face, it's hilarious watching their arm suddenly and magically divert from their face.

You laugh, but I've seen it happen!!! Some kids are professional fakers! I had one girl who didn't even respond to painful stimuli....however, when I told her that her dad was going to have to pick her up early from camp, she somehow managed to snap out of it! It really is psychological warfare. Try to understand where they're coming from, and why they're faking symptoms. Often, the "fakers" have very vague GI symptoms. But the best way to tell is to get to know the kid. Get them away from other campers and use your therapeutic communication skills to get them to open up. Treating homesickness is a huuuge part of the job description :)

Kooky Korky, BSN, RN · May 21, 2012

Assume they're ill until proven otherwise. I hate when nurses start thinking everyone is faking.