Faking It - page 6

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

  1. by   red606
    Lots of experience with psuedoseizures....ha ha. The ones who have spontaneous seizures when they dont recieve the narcs they request. The ones who fight with spouse or significant other...and has psuedoseizure (real MD diagnosis) to pay them back for what ever they did to upset them in the first place...real dramatic. Some are pretty good some are not. Like the teen who stopped seizing long enough for us to drag him out of the car and put him on a stretcher, then start seizing again when we put the bedrails up.
    Or the patient who is faking it and you ask "what are you doing?" The patient replies with a puzzled look on their face "I'm having a seizure" They are disappointed you didnt recognize it.
  2. by   mrh1953
    >What happened to the good ol' days when all docs
    >thought everything was "in your head"?

    I have tried this approach to my own "complaints" (assuming that, as a nurse, I'm inventing stuff I know too much about!). It can backfire, though (and has). Sometimes the woes are truly real and need to be dealt with.

    A faker in the hospital may not have a valid physical complaint, or it may not be the presenting problem (as he or she states it), but it could be real, nonetheless. And probably does need treating, if only in a psych setting at times.

    I may not appreciate the faker's "wasting my time" but I do try to understand what motivates such folks. No one does something for no reason at all... (It's hard, though, when you have to wade through a lot of distracting s/s to find the real problem at the root of it all.)

    I think we have to find a happy medium between all-in-the-head and not all-in-the-head.

    sigh...
  3. by   hogan4736
    3rd shifter...

    you stated (and quoted):"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 genuinely believe that some actually premeditate about how they'll pull their act off, for whichever "chronic" (exacerbation of) illness (seizures, pain, etc)...Is there a psych component there? OF COURSE...but I've got to be concerned about true life-threatening conditions in my patients, or actual pain, etc...
    Maybe this is a stretch, but , should career criminals receive lesser sentences, because of abuse/neglect in their past. ..
    Look, patients w/ psych histories, that consciously make symptoms up for attention, take care away from those that really need it, and it frustrates us all here...If someone calls 911 for what is later to be found a "pseudoseizure", and does it monthly, then, in my world, let's hand him an ambulance transport bill ALONG WITH his therapy...

    sean
    Last edit by hogan4736 on Mar 6, '03
  4. by   hogan4736
    My point is that people should be held accountable for their actions (except some severe cases of mental illness), and we are outraged that patients do this...

    I worked in a long term/residential pediatric psych facility for 10 years...The patients could get into a funk for continually focusing on/blaming current behaviors on past events...Should the past be discounted? NO, NO, NO...BUT, the past should never be used as an excuse for current behaviors, rather to shed light on them...
  5. by   Coldfoot
    When I was in the Army I worked ER on a training post. We got a lot of kids that decided that the military life wasn't for them and a medical discharge was the way to go. (Sadly a lot thought suicide attempts with nasty stuff like Tylenol was the best way out.) We had one troupie that like to fake a siezure in the PX. The first time she did it and got the full workup and then her paperwork was forwarded to the Medical Board. Any time she felt the discharge paperwork was taking too long, she'd go to the PX and "sieze". When one of the new MS4's went into interview her (not knowing what the rest of us did) her responce to the "Do you have any meical problems?" question was "Oh yah, I have psuedoseizures." Don't people research their DX's? She did progressivly get better (at acting) to the point that she would wet herself. She never did get the post-ictal thing down or realize she shouldn't follow any commands.
    Last edit by Coldfoot on Mar 6, '03
  6. by   Tilleycs
    You mean people are actually trying to GO to the hospital or doctor? Yuck. I avoid them like the plague.
  7. by   gizzy76
    Thought I'd add my two cents in here...I've only encountered one person so far in my nursing career that I have thought (as well as others) was a faker.

    A middle aged man came in with abdominal pain. He was given many tests and would sit at the bedside holding his side, rocking back and forth and moaning and groaning. The minute you'd leave the room, there wasn't a peep to be heard. He would walk down the hallway as if he were you or I (with no obvious distress). He'd call approximately 1/2 hr before his pain meds were due saying that he was in great pain and needed something for it. He also called the nursing desk at one point and was making gagging throwing up sounds. I went to see him and he had some phlegm in the basin at his bedside and went on to tell me that he was dry heaving and nauseaus and in so much pain. I left to get him the Buscopan that was ordered and snuck back up to his room. I quickled walked around the corner and found him sitting at the beside with his fingers down his throat trying to make himself puke. I can't describe the surprise on his face! He was speechless. Needless to say, his abdominal pain and nausea quickly subsided to a much lesser evil at that point!
  8. by   l.rae
    gizzy, l wish l had a nickel for everytime l have told a pt....."You need to take your fingers out of your throat"...l have caught many trying to induce the old heave- ho.......we had a "migraine in the other day....walking around the room, laughing and talking loudly w/ visitors, lights on....she didn't even have the decency to fake it...... but she did get some Toradol....LOL!
  9. by   ShelleyERgirl
    Hey guys, I have actually been on both sides of the fence here. I have been diagnosed with temporal lobe seizures since about 1997. However I have been having seizures since 1994 when I was in the Navy stationed in Puerto Rico. They were so bad they thought I had a brain tumor and medievaced me to Bethesda Naval Hospital Maryland for eval. I don't remember the trip because I was pretty much out of it most ot the trip. When I got there every single damn test came back negative and I spent three lovely fun-filled days on the psych ward diagnosed with .... you guessed it.... pseudoseizures! Anyway, fast forward to two years later, two witnessed petit mal seizures later, I am driving home from work, I pull up to my apartment, open my car door and proceed to have the hugest grand mal seizure ever witnessed by the paramedics the were called to my rescue! Funny how this time both my EEG and my MRI both came abnormal this time and how I then have to take Tegretol for a long time and now I currently take Topamax. Pseudoseizures? I don't think so. Anyway, I know that there are fakers out there and I have seen my share but I am definitely not one of them.
  10. by   Little One2
    Wow, that is pathetic that people would fake being sick. Take up beds for those who really need it.

    It is no wander emergencies are always full. Everybody comes in for every little cut or scrape.
  11. by   Tweety
    Originally posted by hogan4736
    3rd shifter...

    you stated (and quoted):"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 genuinely believe that some actually premeditate about how they'll pull their act off, for whichever "chronic" (exacerbation of) illness (seizures, pain, etc)...Is there a psych component there? OF COURSE...but I've got to be concerned about true life-threatening conditions in my patients, or actual pain, etc...
    Maybe this is a stretch, but , should career criminals receive lesser sentences, because of abuse/neglect in their past. ..
    Look, patients w/ psych histories, that consciously make symptoms up for attention, take care away from those that really need it, and it frustrates us all here...If someone calls 911 for what is later to be found a "pseudoseizure", and does it monthly, then, in my world, let's hand him an ambulance transport bill ALONG WITH his therapy...

    sean
    Again, I wasn't talking about those patients. But I read what you had to say. Thanks for sharing, you opinion is appreciated. (I never did say fakers didn't exist.)
    Last edit by Tweety on Mar 8, '03
  12. by   Scavenger'sWife
    Originally posted by deespoohbear
    OMG!!! That is too funny!!

    What did the nurse say back to him?
    Deespoohbear......sorry...I didn't read this thread again until today!

    The nurse just folded her arms across her chest and told Lou that she would be back when his seizure was over!

    He was quiet the rest of the day! :chuckle
  13. by   igloorn93
    When I worked in ICU on nights years ago, we had a run of attempted OD's. We had decided to write a book "Suicide... the right way to do it". People who take 15 tylenol and then complain with the mucomist treatment get me all the time. I just shake my head and want to say "DUH", esp when they are repeat offenders with the same kind of OD. You think they'd figure it out.

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