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Munchausen Syndrome

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kabenkula kabenkula (New) New

I recently had a patient diagnosed with Munchausen Syndrome admitted to the surgical floor for surgery. This patient was placed on suicide precautions. Because I don't know much about this sydrome, does anyone know if they are at an increased risk for suicide? I thought that with this syndrome, the patient was more interested in gaining attention versus actually committing suicide. Does anyone have any information for me that could help in the future?

I would guess, without knowing anything else about the situation, that she was placed on suicide precautions so that she would be continuously (or v. frequently) observed, not because of a fear that she wants to kill herself but because of the risk of her doing other non-lethal but dangerous things to herself -- but "suicide precautions" are what that level of observation is called at that facility, so that's how the order is written.

I would guess, without knowing anything else about the situation, that she was placed on suicide precautions so that she would be continuously (or v. frequently) observed, not because of a fear that she wants to kill herself but because of the risk of her doing other non-lethal but dangerous things to herself -- but "suicide precautions" are what that level of observation is called at that facility, so that's how the order is written.
exactly what i was thinking....this was the way to get her the care that she required..

melmarie23, MSN, RN

Specializes in L&D/Maternity nursing.

I guess it depends on what they were doing in order to get attention.

what is the scheduled surgery?

sirI, MSN, APRN, NP

Specializes in Education, FP, LNC, Forensics, ED, OB. Has 30 years experience.

These individuals are at risk for "accidental" suicide. Many will try and exacerbate their symptomology by self-inflicting wounds (opening surgical wounds), ingesting substances (injecting pus in an IV, wound), avoid early treatment of a real problem in order for the condition to become serious, etc. Thus, the suicide precautions necessary in their care.

Mortality/Morbidity

Although patients with Munchausen syndrome are generally medically knowledgeable and sophisticated, their manipulations sometimes result in unintended serious injury, permanent disability, or death.

http://emedicine.medscape.com/article/295127-overview

The previous posters did a good job explaining why. I'm curious, how interesting to get this case.. Did she talk to you at all about her condition???

This patient was scheduled for abdominal surgery to have the bracelet removed that she inserted into her abdomen. My shift ended before she went to surgery, and I haven't worked since, so I don't know about the patient's post-op status.

Munchausen is much better than Munchausen by PROXY!

diane227, LPN, RN

Specializes in Management, Emergency, Psych, Med Surg. Has 32 years experience.

Hard problem to treat. I have seen a lot of people with this problem and it is very often fused with borderline personality disorder. High risk for accidental suicide.

Sorry, I'm so late in responding. No, she didn't talk about her condition. She just mentioned that she had had previous stomach surgeries and during my assessment, noticed several scars on her abdomen.