Faking It

Tweety, BSN, RN · Feb 21, 2003

Originally posted by hoolahan
3rd shift guy, not to be a snot, but maybe you haven't seen this so much b/c our dear ER colleagues have already triaged or treated and streeted the fakers w all their assundry miraculous cures that I am learning about tonight.

That's exactly what I was thinking. I hope I brought that point across. Sounds like the number of people who present to the ER with fake symptoms outnumber the ones with pysch illnesses who truly don't know they aren't actually sick.

However, my point being that "faking seizures", not the ones who go "gee, I'll fake a seizure and get drugs"., but the one's that have spontaneous psuedoseizures is a condition. The same as "clinical depression" is.

These people deserve to be treated with respect. Not laughed at, not talked about in the hallways that they are "fakers".

The unit I just left had continuous video eeg monitors and we would get patients on a direct admit basis. People who have thought they've had seizures for many years. Whom even "fooled " ERs and doctors, being on anitseizure meds. (Because you don't have to flipflop and piss on yourself to have a seizure) (Sometimes, it's very obvious that a person isn't having a true seizure.) The monitors tell the truth. They are then sent for proper help, not sent on their way chastised for being "fakers", just for drugs and attention.

I'll get off my soapbox. LOL

perfectbluebuildings, BSN, RN · Feb 21, 2003

We had a lady once at this assisted living place who would pull out her fully inflated foley catheter to soak her just-put-on outfit if we didn't get there fast enough to change it to something she preferred, then would say it just slipped out... with only 3 cnas/ras and no other staff but the cook for 50 residents, that was annoying!!

rachel h, BSN, RN · Feb 21, 2003

We have a patient who comes in the hospital all the time for "pain crisis"- last time I took care of him he was getting dilaudid q1-2h (and was on his light every hour on the hour), rating his pain 10/10. As I'm giving him dilaudid, he says to me " I wish the hospital had a weight room so I could go work out."

Unbelievable... he was taking up all my time so he can get high while my other patients have to wait longer for what they need because he wants his drugs every hour...

Last time he came in the docs wouldn't give him any IV meds and he left the next day...

FullMoonMadness · Feb 21, 2003

We have a frequent guest on our floor who has such sevr pain she states she can't eat.Routine orders are MS Conyin 80 TID with a little IV morphine for breakthrough pain. Last visit she was on maintenance fluids and NPO because of a new gastric complaint,

" I cant eat it hurts my stomach,havent had anything in 3 days". I went in her room and thought she was bleeding from her mouth at first glance,head slumped over on chest.On closer exam,it turned out she had put a Snickers in her mouth and nodded off. The "blood" was melted chocolate!

welnet66 · Feb 21, 2003

I 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

Cath

RN-PA, RN · Feb 21, 2003

FullMoonMadness'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.

:stone

hoolahan, ASN, RN · Feb 21, 2003

Thespian Seizures! LOVE IT!!! :rotfl:

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.

dawngloves, BSN, RN · Feb 21, 2003

Originally 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.

Darn right it is! That is child abuse!

dawngloves, BSN, RN · Feb 21, 2003

I 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!

l.rae · Feb 21, 2003

you 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

kaycee · Feb 21, 2003

Originally 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.

3rdShiftGuy,

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.

Tweety, BSN, RN · Feb 22, 2003

Kaycee, 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.