how can you tell a drama queen?

[purse]

:banghead:We have this lady at my work (LTC) who is known to be a drama queen, she is always in some kind of pain, ANYTHING you can think of she has it. Anyways, she has had 3 strokes in her lifetime which is why she is there, (she is fairly young in her 70s) BUT, she is ALWAYS saying she is having a stroke! Everyone else just 'knows' she is a drama queen and just ignore her, but for some reason, I always think "well what if she really is having a stroke and I just ignore her like everyone else"

I always take her vitals, and they are normally fine, I even sent her to the hospital once just 'because' she thought she needed to go, she was on the call light every 5 minutes, so i just sent her.

So does anyone have any tips of how to deal with the drama queens out there?!

She is constantly crying and in so much 'pain', and always wants to go to the hospital, but then she gets sent back the same day!

UGH its driving me nuts, because she does have health problems, and there is going to be tha one time noone does anything and there really is something wrong!

[leslie :-D]

i agree about psych eval, prns, pain assessment, and NOT enabling her anxiety by sending her out ad lib.

this thread reminded me of a nurse i worked with yrs ago.

back then, she was in her early 40's, and constantly complained about any of her thousands of ailments.

after awhile, we just let her rant/complain and paid little attention to this 'hypochondriac'.

well.

she took a position at another facility

and wouldn't ya know, this nurse died at the age of 44.

it was from one of the ailments she complained about.

since then, i've been highly cautious of how i process complaints.

i felt *this* tall when i learned about m.

be careful...

you just never know.

leslie

[morte, LPN, LVN]

I'm not sure. If she has no family and has a conservator, it usually required an order to go to the ED at the LTC facility I worked at. "Just wanting to go" even if not mentally incompetent wasn't a reason to go unless accompanied by signs and/or symptoms of something that warranted a trip to the ED.

Strokes do weird, weird things to people. We had a couple of people always on the call light, and to be honest, I just learned to deal with people. I work in psych now and we have a few guys who ALWAYS complain. We basically go through the motions: sit them down, quick assessment of area of complaint, take vitals, tell them that their vitals are normal, they aren't exhibiting signs of what they are complaining about, and that's it.

Does she have any PRNs for anxiety? What are her normal medications? Not really enough information. Sounds like you all have work to do in your administrations next care plan meeting.

If the patient has been conserved, he/she has been adjudged incompetent.

[psu_213, BSN, RN]

inre: the above bold......if she has not been declared mentally incompetent it is her right to go to the ED.

If this is the case the would you not have to send her to the ED with her first request? If she is ringing q5 minutes to be sent out, would this not mean that her original request was igonored?

[morte, LPN, LVN]

If this is the case the would you not have to send her to the ED with her first request? If she is ringing q5 minutes to be sent out, would this not mean that her original request was igonored?

1) technically yes

2) probably

[sharpeimom]

as someone who had her first stroke at age 13 months, caused by a congenital aneurysm, another at age nine, and a leaky aneurysm (yes, another one) repaired at age thirteen, and another stroke the day after my 54th birthday, i can personally attest that strokes can and do change you forever. they cause a never ending fear that another one is just around the bend. if no one seems to take you seriously, it's even worse than it needs to be. at first, you are terrified to be alone, but eventually, if those around you are patient, you get over most of it. it took me almost two full years before i could stay alone, while my husband worked.

when i regained awareness, i didn't know my husband, my internist, or my aunt. gradually my memory returned. in the interim, however, i was terrified. regaining my memories happened over the next three years. i simply had to trust that the people around me wouldn't hurt me and would really listen to my altered speech.

your patient may well be terrified every moment -- even while asleep. she may have trouble telling you exactly what scares her. in rehab, i was continually told that after discharge home, i must go right to the er if and when i even thought i might be having symptoms. something you just ignored pre-stroke, becomes magnified 1000x. i don't know how to explain it so it makes sense, because it isn't rational. it just is.

how recent was her stroke? how long ago did she have a neuro eval? what about a psych eval? sometimes just being able to have a few sessions with a psychologist to rant, rave, and have someone

really listen to you can help a lot.

post-stroke, people tend to treat you as though your i.q. lost 100 points, or as though you're over dramatizing your stroke symptoms for effect, or as though you should always remember to be properly grateful for everything people help you with. "aren't you lucky he has you out today?" has

me out? he is my husband and we've always done things together, thank you very much!

please give your patient the benefit of the doubt, because i can practically guarantee she isn't trying to drive you crazy. you live a day at a time always knowing the next one, the fatal one, -- or worse yet --

the one that doesn't kill you, just impairs you even more, may happen in ten minutes, ten days, ten months, or never.