Faking It - page 7
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
Mar 8, '03Okay, I work agency. I was at one hospital one night. this guy comes in claiming a history of dvt s to his upper arms. They put him on heparin gtt. So the @@S hole is yelling in pain. So, with 6 other pts, I spent half my night on pain control for him with part of this time being on the phone with the doc. To get this guy stronger pain meds. So, my night ends going home feeling sorry for this guy.
Two nights later i am in another hosp and the same guy is there with t he same complaint. But now they have him on a pca.
So I call the doc and he orders a search of all the hospitals he had visited that week and also a search of rxs he had gotten. I was mad! I asked the doc if I coul write an order for a vastectomy for this guy but he wouldnt do it. Instead he is looking at some serious felony charges. One being insurance fraud.
Mar 8, '03Ive probally had at least 20 people with "abd pain" this past year.
They want thier pain meds iv. They are "allergic" to anything po, unless it is oxycontin of course. Sorry, but I dont feel sorry for the fakers. Psych case or not.
But I do treat them like any other pt I have with "real" pain. Im not there to judge someones pain for them, I cant. I can just try to help control it. And if they need a psych eval Ill have the doc order it. These "fakers" do need help, but not on a non phsyc unit.
Mar 9, '03funny how the abd pain fakers always ask for something to eat....l don't think so. 3d shift guy...l still find your statement about ppl not planning a trip to the hosp fascinating.....l am not badgering about it, but it calls to mind a distant relative....many yrs ago, she was so hooked on soap operas that l believe she lost the ability to separate fantasy and real life.....this was back in the 60-70's....she had every malady and tragedy that her soap stars did......and when they got pregnant, she would too and talk about how her and so-and-so were expecting....if it weren't so pathetic it would be hilarious.....of course this was back in the day when there were only about a half a dozen soaps on the tube, otherwise....l think the population increase would have been off the charts...LOL.....
Mar 9, '03Originally posted by l.rae
funny how the abd pain fakers always ask for something to eat....l don't think so. 3d shift guy...l still find your statement about ppl not planning a trip to the hosp fascinating.....l am not badgering about it, but it calls to mind a distant relative....many yrs ago, she was so hooked on soap operas that l believe she lost the ability to separate fantasy and real life.....this was back in the 60-70's....she had every malady and tragedy that her soap stars did......and when they got pregnant, she would too and talk about how her and so-and-so were expecting....if it weren't so pathetic it would be hilarious.....of course this was back in the day when there were only about a half a dozen soaps on the tube, otherwise....l think the population increase would have been off the charts...LOL.....
Didn't mean to imply there aren't many people who go to the ER faking. I know there are lots of drug seekers that go to the ER specifically for drugs. They go with all sorts of ailments, abdominal pain, back pain, migraines, and seizures.
I just didn't realize that people think, gee I need a fix, so I'll go to the ER and have a seizure. Now I know better.
HOWEVER, there is a condition called psuedoseizures where the person doesn't consciously decide to have a seizure. Now their seizures are not by the book, they talk during them, the are not incontinent, etc. But they genuinely believe they are having seizures and not because they want to get high.
I'm trying to distinguish these patients from drug seekers.
It's a condition, kind of like depression, or alcholism, or pschizophrenia. It obviously isn't common. But since we have the video monitor studies, perhaps I've seen the more often than not.
Just don't think that everone who is having a fake seizure is looking for drugs.
End of lecture. Again. LOL
Mar 9, '03Sad. I have occasional severe migraine headaches. Once when I went to the ER, a doc actually came out and accused me of drug seeking- the a$$hole.
Most times, the docs would only give me Naprosen- for migraine!
So, I'm paying a $100. ER co-pay, and waiting for hours in severe pain to get a f#$%%^ Naprosen?
Not until injectable Imatrex came out, was anyone who worked in an ER willing to address my pain.
ONLY when this effective non-narc became available could I get any relief in an ER.
The fakers and drug seekers have caused ER staff to not believe those of us who have REALLY been in severe pain.
Mar 9, '03Working the special needs unit , I see MANY behaviors....but many we find are px related. Rx the px and the behaviors disappear. Granted in ED this doesn't apply.....but in LTC....It works for us...
Mar 9, '03Malingering seems to steal resources, but in all actuality the client is still trying to meet some type of need. Commonly occurring incidents are Med seeking, superficial cutting, nebulous somatic complaints, maybe even years of incessant SI etc.
Even though the end result of this type of client's problem doesn't necessarily meet the "true need" that drives this behavior, to the client and their level of functioning or coping, there may simply be no other way to meet their needs and we may choose to wind up frustrated and impatient with the recidivism.
Treating the need rather than the symptom can't be done in an ER or short term setting realistically, but just this type of realization ( client ineffectively attempting to meet some need )
- at least for me -- makes dealing with these patients easier and keeps you more professional. Besides, we all get payed the same regardless of the clients coming through the door.
Mar 9, '03I too have seen my share of fakers in the past 25 years. But this is about a nurse that accused everyone who wanted pain med as being a faker. We had one guy that had a bad heart and had had it for so long, that he did not just toss and turn when he was having chest pain. ONe nurse told in report that he got his morphine but was not hurting, she said his telemetry did not show anything. I told her that unless he was having an actual heart attack, the telemetry probably would not show it(this was told to me by a doctor). This nurse never again told me that he was faking. That nurse left and went to work somewhere else and not long after that, this gentleman had a heart transplant. Guess he was not faking.
Mar 9, '03I worked psyche for a couple of years...........a whole new perspective on faking.............and, while I agree that a lot of times the faker is trying to meet a need, giving in to a patients maladaptive ways of meeting their needs doesn't fix the problem either............. truly believe that an offer of a psych consult is best "fix", whether is drug seeking, attention seeking, whatever..... and, if by some error there truly is something seriously wrong, they are under medical supervision, so can be treated that much more quickly............True, many will get angry and leave, but always possible that you have made them seek a more appropriate method of meeting their own needs.......
Mar 9, '03lt;s never safe to assume someone is faking......honestly, there is a whole package of red flags that lead to this deduction.....l feel bad for you Hellllonurse, there are nurses out there that have no compassion.....and besides, it is unsafe to assume you are correct in charging pts with faking, l believe one should get the benifit of the doubt....doesn't necessarily mean they will get the drugs they want.....but those who get beligerant at the mention of toradol, or are allergic to every low key pain reliever known to medicine, no family doc...even though they were referred the last 6 times they were in.....and on and on.....after a while it is painfully obvious....pardon the pun...
Mar 12, '03I was working at a state psychiatric facility, one of our patients had a certified Dx of Epilepsy. He was noted during his seizures to sometimes "cop a feel" on younger aids, nurses. Once while "having a seizure" after a traumatic "not getting his way" a cigarette lighter came out of his pocket and slid on the floor. No lighters were allowed on the psych unit, staff lit cigarettes. I observed him, as he was having his seizure, slowly reaching for the lighter, which I got before he did, he was really POed then. LMAO
Jan 27, '04I'm doing a research paper entitled "Mental Illness: An Excuse For a Crime?" and a major aspect I'm trying to cover is on people faking mental illness'. In doing my research, I ran across this bulletin, and after reading through most of it, I was wondering if anyone had any suggestions on either: resources, or just some nursey knowledge :-)
It would be a tremendous help!!
Jan 27, '04My all time favorite. MD and nurses watching pt have "seizure". Pt was doing an excellent job but then blew it when the doc said "Wonder what he takes for his seizures?" Pt. stopped seizing long enough to say "Valium" then went right back to seizing.