[l.rae]

the best, the worst......what's your experience with pt's faking illneses etc?......seems lately at my ER, seizures seem to be the malady of choice.....l have decided to earn my retirement writing a book on how to fake a realistic seizure......the do's and don'ts....the other evening we had a chick having a "seizure".....full body, but she could talk and make eye contact....hmmm, AND....when l triaged her and asked her if she was having any pain, she said "yes, my chest where the nurse pinched me yesterday"....uh, yeah....she was in the day before with the same c/o. One time, we even cured a sz with a miricale drug called sodium nacl....(pronounced: so-de-um na-kel)..........

tips:

1 do not make eye contact

2 do hit your self in the face with your arm when it is dropped on your face.

3. do not tear up when the amonia cap is broken

4 do **** yourself

5. puking is always effective

ok, that's all l can come up with for now, and l am bored of war talk.....please help me earn my retirement

[Stormy]

I once saw someone fake paralysis (sudden onset - no history of trauma). This person was pretty good at faking quadriplegia...but only until examined by the neurosurgeon. It was amazing to watch her response, or lack of response to painful stimuli.

[kaycee]

6. "HEY, I'm having a seizure here"

[Tookie]

I am sorry - Ive just come home and my first thought was - its a bit hard to fake it when you get as far as the nursing home - However there are a few residents that keep knocking on those doors - but the gates wont open - Sorry l should be seeroius.
Tookie with cheers

[emily_mom]

Oh God, we have one now. The guy was abused as a child and married and extremely older woman. We think it's kind of a Munchausen with them. He is in at least once a month, for sometimes as long as a month. This time his port a cath was infected. Why does he have a cath? We don't know either. It was put in at another hospital (which no longer sees him d/t the whole situation).

Some recent situations: wife leaves....IV infiltrates (cath was removed...new one put in...*********)

dad leaves...starts puking in lounge bathroom. I open the bathroom door...no smell, no vomit.

Daughter's b'day party at hospital....falls in bathroom when he was at the sink. Come running in and the way he is laying isn't conducive with what he describes. Vitals perfect.

He has been in for 5 weeks this time. Docs can't figure out what wrong with him. Family looks on internet all day in room for diagnoses. Want to tell them to do a search on "psych consult" but hold my tongue.

The guy weighs 250 lb yet is unable to keep anything down at home, so he was getting TPN. Weight jumps up. In the hospital, he can eat anything and is normally ok until he has an episode.

I think the docs suspect something, but are dragging it out. Now he has a PCA b/c "it hurts so bad" when he poops.

Major PIA.

[Heather333]

Originally posted by emily_mom
Oh God, we have one now. The guy was abused as a child and married and extremely older woman. We think it's kind of a Munchausen with them. He is in at least once a month, for sometimes as long as a month. This time his port a cath was infected. Why does he have a cath? We don't know either. It was put in at another hospital (which no longer sees him d/t the whole situation).

Some recent situations: wife leaves....IV infiltrates (cath was removed...new one put in...*********)

dad leaves...starts puking in lounge bathroom. I open the bathroom door...no smell, no vomit.

Daughter's b'day party at hospital....falls in bathroom when he was at the sink. Come running in and the way he is laying isn't conducive with what he describes. Vitals perfect.

He has been in for 5 weeks this time. Docs can't figure out what wrong with him. Family looks on internet all day in room for diagnoses. Want to tell them to do a search on "psych consult" but hold my tongue.

The guy weighs 250 lb yet is unable to keep anything down at home, so he was getting TPN. Weight jumps up. In the hospital, he can eat anything and is normally ok until he has an episode.

I think the docs suspect something, but are dragging it out. Now he has a PCA b/c "it hurts so bad" when he poops.

Major PIA.

That's why I will NEVER EVER go back to adults. I'll stick w/ the micropreemies.

Heather
Heather

[HLR_RN]

We have one pt on our floor who is admitted every couple of months or so for a GI Bleed. She has a central line d/t numerous (and probably bogus) admissions and no veins. Well, the one night I was looking after her, she called me to her room. She'd had a huge bleed. Problem, no melena, no blood clots, just BRBPR. I'm doing her vitals and notice the central line, blood backed up into the lines and blood all over the end ports. Then I see blood all over her fingers and nails. I ask her about it and she "doesn't have any idea what happened. Will I call the doctor now?"

Scariest thing about the situation--This woman is a nurse!!!!

[Allison S.]

We see a lot of this under our chronic pain program for kids.

1. one whose reflex sympathetic dystrophy "moved" from limb to limb as discharge approached.

2. One whose legs went numb causing falls, but only in front of the objects of crushes.

3. One who had pain for the last three years, but only between the months of September and May. (i.e. when the patient was supposed to be going to school -- hadn't gone in years).

We treat them all the same. Whether we believe the pain is real or not, we try to give them methods to cope with it and resume normal life. My personal philosophy is that even if they are faking it for attention, they obviously need attention.

Interestingly, among the kids we see a lot are those who were sick as young children, so watch out for those micropremies.

[l.rae]

we have had several "psych" pt's who are RN's lately.......part of me just says.."no freakin wonder"....and there are several pt's that are highly suspect of munchausin's....the other nite l was at the nurses station and in a casual conversation l used the term frequent flyer.....one of the nurses in a room across the way gives me a look.....l say what???...turns out all she heard was the FF term and right next door was one of our best customers!..........how about some OB stories???...got to be some great fakers there...LOL!

[shrinkyrn]

I work psych/substance abuse-- see "pseudo" illness all the time, our dilemma is-- what if it's the ONE time it ain't fake!!!!! I have a tendency to downplay illnesses with these folks-- but, I work with some nurses who play right into the histrionics!! Talk about the ability to split staff!!!