Opinions wanted!

[WinterLilac]

So everyone, I've come to you before to get your advice and it's been incredible. You all have different opinions but back them up with rationale, true nurses!

I would like your advice/opinion once again. Here goes:

Background: I am one of 3 clinical staff working at a non-government mental health service. Just recently, I was asked to create a new activity group which has happened and is going well. At our first group activity, a client who I have worked closely with, exhibited a non-epileptic seizure. Historically, I organised clinical testing for her, received the results and recommendations from the neurologist and treated this client accordingly. She went well and responded to the treatment. She was not epileptic, her 'seizures' were purely psychosomatic.

When she has a 'seizure' the recommendation is to pay her little attention when she places herself on the floor and begins the 'seizure'. She has deep-rooted issues which I am closely working with her on. During the 'seizure' I stood near her to ensure her safety but didn't give her the attention she was after. It sounds callous however due to it being behavioural, it works well to remind her it is not appropriate to affect other clients enjoyment of the activity to focus on her.

Two colleagues, one who was not even there when she had the 'seizure' attempted to make a complaint against me for reasons they couldn't really specify. My actions were backed up my senior clinical colleagues and it is clear they acted out of jealousy.

My question:

I will be addressing this issue directly with the two staff members concerned. How would you address it with them? What would you say?

I look forward ward to your responses. Again, this client is receiving comprehensive treatment for her non-epileptic seizures and I have a good rapport with her. My actions were not of malice nor disregard.

[Meriwhen, ASN, BSN, MSN, RN]

Not all seizures are the full-on grand mal (tonic/clonic) type. Not all seizures cause a loss of consciousness. Not all seizures require the person having them to have a diagnosis of epilepsy either. And the poorly-named pseudoseizure is not as the name may imply and is a faked condition, but is an actual medical issue. There's a lot more to seizures than one may realize.

And treatment of the patient during most (not all) seizures is usually nothing more than ensuring that the patient is safe and breathing until the seizure activity ends. Which is exactly what you did. You really can't do much else while they are actively seizing.

Not saying that your patient isn't milking the seizures for attention or whatever reason--I wasn't there and I know nothing about the patient's history.

But I can see there is a knowledge deficit in your staff regarding seizures, and some education on seizures and the various types, causes and management would be beneficial.

[WinterLilac]

Not all seizures are the full-on grand mal (tonic/clonic) type. Not all seizures cause a loss of consciousness. Not all seizures require the person having them to have a diagnosis of epilepsy either. And the poorly-named pseudoseizure is not as the name may imply and is a faked condition, but is an actual medical issue. There's a lot more to seizures than one may realize.

Not saying that your patient isn't milking the seizures for attention or whatever reason--I wasn't there and I know nothing about the patient's history.

But I can see there is a knowledge deficit in your staff regarding seizures, and some education on seizures and the various types and causes would be beneficial.

Appreciate your input. It is clearly understood the points about seizures, I will be providing education regarding this.