Faking It - page 5
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... Read More
Feb 21, '03I work on a neurosurg/neurology unit and the most common faker we see is seizure, with paralysis coming in second. We can't figure out what the attraction is but since it is so common we developed a new name for this disease process. It's called Thespian Seizures!:chuckle
Feb 21, '03FullMoonMadness's post about the patient asleep with a Snickers Bar in her mouth remended me of a patient years ago who was admitted with severe abdominal pain, was NPO and getting narcs for pain. A nurse from our unit was in the hospital snack bar and saw the patient buying 6 candy bars.
Feb 21, '03Thespian Seizures! LOVE IT!!!
3rd shift, we aren't in the hallway snickering here, but I see your point about that. I don't think this thread was intended to poke fun at people who seriously need help, but come on, you don't think some of these descriptions are hilarious? I guess I am cold-hearted b/c I am LMAO! For example, we once had a 16 yr old shoot himself in the head, but didn't die, was admited herniating brainstem and proceeded to brain death before anything could be done to stop it at a community hospital w/o trauma team on-site. When told his brother was brain-dead and would die, his 18 yr-old brother asked, "Can I donate half of my brain to him?" A question like that is heart-breakingly ignorant, but on the other hand, I find it funny in that morbid tension-relieving kind of way.
Feb 21, '03Originally posted by JNJ
Horrible incident, but the RN probably saved the kid's life long term, and certainly his health. Took it's toll on my friend.
Not sure if Munchausen by proxy - as this is officially called - is really a law enforcement matter. Seems to me the mother needs a psyche consult more than anything.
Feb 21, '03I vaugely remember hearing of a large pt that had grand mal seizures where he would somehow end up on the floor despite side rails x4. They put his mattress on the floor and he was cured!
Feb 21, '03you guys are too funny....l gotta get offa here and get to work.....sigh....l am enjoying all of your responses...thanks....3dshiftguy, when l have more time, l am going to do a google on pseudosz.....l would like to learn more...if you have any good links to info please post them.....mean time...l'm off to a 12 hr shift of Jerry Springer........JERRY JERRY JERRY JERY JERRY!.............later......LR
Feb 21, '03Originally posted by kaycee
Our repeat seizure offender was after IV Valium and Ativan. And I would say yeah he did say I think I'll call 911 and go to the ER and fake a seizure for my nightly high. When we wouldn't give him any meds and would just watch him preform, he would eventually get off the stretcher and walk out AMA.
If you were talking about me laughing at the pt, I don't see that anywhere here. We just didn't rush over everytime he decided to have a seizure. After he didn't get the attention or drugs he was seeking he would get off the stretcher and leave. We tried numerous times to talk with him and refer him to psych but he would never follow up and would get angry and belligerent. I felt sorry for him and yes I do believe he was sick. There's only so much you can do for people who don't want to help themselves.
Feb 21, '03Kaycee, sorry I should have been specific. I was talking about cindyln's "had all of us laughing at him" post. My post had nothing to do with yours. It has nothing to do with drug seekers.
I don't mean to sound all self-righteous here, like I have no sense of humor. God knows, we have to vent and talk about our "performers". I worked with a nurse aide who was a hoot. We worked trauma and after leaving the room we would joke "and the winner of the Academy Award for most dramatic performance is....."
The patients I'm talking about are NOT the one's faking seizures to have get drugs.
But when there are comments from a nurse like brefni's "I don't understand what the attraction is..." it bothers me. There is no attraction, there is no though process "gee, I think I'll fake seizures to get into the hospital and get some attention, drugs, or to perform". As I said before, it's a pysch illness same as depression, or phychosis, amnesia etc.
I really am fun to work with, but I also feel that psuedoseizure
patients (not drug seekers) are misunderstood.
Not that their "peformances" are worthy of comments. And perhaps you can't help but snicker when during a "seizure" they do funny things.
I'm not going to allow myself to be on the defensive here. I know most of you are very good people here, very professional and excellent health care providers.Last edit by Tweety on Feb 22, '03
Feb 22, '03Hey no problem 3rdShiftGuy. It's easy to get misunderstood on a bulletin board. I do understand where your coming from and you don't need to be on the defensive. Never doubted you are fun to work with as are I'm sure, alot on this board, including me. I enjoy your posts and especially your sig line. Take care.
Feb 22, '03Thanks for understanding Kaycee. (Sometimes it is very hard for me to make myself clear and understood and I will beat a dead horse into the ground to make myself at least understood, not necessarily agreed with.)
NOTE: I did edit my post to say "the patients are NOT the one's seeking drugs"....
So, I'll let it go now. LOL
Feb 22, '03Heh these are great - I have seen many fake seizures/paralyasis/unconciousness cases over the years...
But here is one from my traveling days that still makes me shake my head -
Patient was on high doses of IV Aminophylline and Floxin for respiratory infection and asthma (clue #1) - was told in report she had been diagnosed with psychosis and that she was acting up to impress her family and she was refusing to talk to anyone or make eye contact with the nurses so she must be faking it.
She was having continuous (real) seizures and had been for DAYS!!!!
Called small town doc in the middle of the night to discuss this with her and she replied "Oh - Seizures???? REALLY??? Are you SURE?............what should I do?"
Had one case of a woman claiming to be paralyzed from her neck down after a fall at her first day at her new waitressing job - we left her the bedpan and when we returned she had filled it with pee and set it on the chair next to the bed - with no assist!!!!
Mar 5, '03Wow! There must have been a seminar in January called "How to fake a seizure and win an Oscar for it."
Early this AM the unit I was on today had a patient admitted from the ER with Dx of uncontrolled Seizures. Okay....First thing patient asks me for is "my Demerol 50 and Visteral 50"
"Hmmmm!" I think....she just got her last dose at 0530 and its only 0830. She then says I feel funny....I think I'm going to have a seizure.
0930....gave pt her pain meds...says she feels hazy...and she might have a seizure. Hmmmmm????
Of course its Ash Wednesday and there are nuns/preists all over the hospital (Catholic Hospital) giving communion and blessings with the ash. Its 1030 and First seizure comes just as the nun is finishing the blessing....She's thrashing around in the bed, making grunting noises, her eyes open and close.
Neurologist, Nurse manager, and two other nurses witness the seizure. After the seizure is "finished" she opens her eyes and says "Did I have another seizure?" Almost everyone had to walk out of that room at that point. Neurologist examines. Writes progress note: Pseudoseizure witnessed this AM. Please do CAT scan, MRI, and Psychological eval."
Second seizure happens at lunch 1200. Aide witnesses....walks out in the hall and grabs me....I time the seizure and another nurse says "Does she have food in her mouth?" .....The food comes flying out of pt's mouth. Don't need to try to get it out now. Seizure stops and pt says "Oh my God, I had another seizure. I'm so sorry!" What for I think????
Explain to patient of all the tests and medications we will be doing, but do not go into detail. "The doctor will explain!" I say....since 1300 she did not have another seizure. Asked for pain meds again an hour before they were due....back hurts a little.....doc was just in to increase the dose to 75mg.
And she just can't stop shaking and having sharp jerking spams.
She needs a muscle relaxant she says....but doc says "no way" Spams get worse immediately.
Hmmmm....Pseudoseizure for Dx on this one....along with Drug addict, DT's, and possible abusive situations at home.Last edit by Flynurse on Mar 5, '03
Mar 5, '03BTW....did I mention the Neurologist had just visited her before the first seizure......AND none of the meds any of her docs put her on helped....AT ALL!