I am a new nurse still orienting to the ICU, so yes, I am very green. I had my first experience with what was originally thought to be grand mal seizures but was soon suspected to be pseudo-seizures. The whole experience was mind boggling to me. The seizures were whole body spasmodic lasting for less than 30 seconds, no loss of bowel functions, no post-ictal (sp?), completely coherent within minutes, some expiratory wheezing afterwards, eyes responded to stimulus, and always occurred soon after the patient was emotionally upset. She had a seizure while she sitting in an upright chair and amazingly did not even end up on the floor or get hurt. I might also add that the seizures NEVER occurred as long as someone was in the room with her and giving them her full attention.
The pt. was completely noncompliant with the nursing staff, refusing to stay in bed (even though we explained REPEATEDLY the danger of being up with the frequency of the seizures), tearing leads off, even attempting to walk off the floor half naked to drive herself home. She went ballistic when she overhead the possibility of restraints. She swung from being completely happy, to being anxious, to crying, to apologizing, to screaming, etc.
As the shift went on more and more information came out - she was a frequent flyer and many of the staff remembered her from years prior at different hospitals. It was very difficult to decipher what of her history was true or not as she has changed doctors quite often.
She was currently on Dilantin, and surprisingly enough, NO psych meds. We ended up having someone come from another floor to act as a sitter and she seemed as happy as a pig in mud then. I was not her primary nurse and an still wondering why a psych consult was not ordered for her.
I have no psych experience and am completely naive in that way but I just couldn't believe someone would put themselves through the physical and emotional hell she was going through just for attention. I guess my question is has any had any experience with this? What would you have done in this situation?
