Staff Member with Pseudoseizures

Specialties School

Published

Hello! I have a coworker who has been diagnosed with psychogenic non-epileptic seizures (pseudo seizures). She has had several episodes on campus requiring EMS transport, she experiences violent convulsions lasting from seconds to 15 minutes, her post ictal phase seems to last hours to days. We have had to put the school on soft lockdown to keep students from witnessing the convulsions, 2 staff have been injured from her falling on them or while responding to her seizures and she has no idea when they are coming on.  She was cleared to be on campus by HR and I am feeling so unprepared to deal with the situation. 

We have no emergency response (other than general seizure first aid), she wants me to put a lorazepam pill in her mouth, WHILE SHE IS CONVULSING, to stop the seizure (which makes zero sense to me, from a pharmacological stand point, and I refuse to put anything in her mouth), and after the seizure is over, she wants to drive herself home. 

I am not sure how to proceed. Since she is a staff member, not a student, I don't technically have any access to medical information, nor am I permitted to be a part of the safety planning. But I am still expected to respond if she has any episodes. 

How would you approach this situation? My main concerns are: her physical safety, physical safety of the staff responding to her needs, student mental health after seeing/hearing the episodes, my liability for any injuries or for sending her home in her car. (I obviously refuse to be involved with allowing her to drive home, but I don't know how to prevent it.)

Thank you for any input ?

 

Specializes in School Nurse.
Cattz said:

I have another thought. I'm not sure what State you are in. But, this type of hard situation is one that I would contact my State School Nurse Supervisor about for further guidance.

Sure hope you had a quiet day. ?

Our school district does not have a nursing supervisor/director and I am not aware of any state level supervision for school nurses.  

Is that someone you contact through the board of nursing or board of education? 

Specializes in School Nurse.
k1p1ssk said:

When I worked in Peds specialties, our Pedi Neuro said that there was a correlation between kids with pseudo-seizures and an "affinity for large stuffed animals and pillows". In other words, these kids' subconscious self knew enough that these episodes would be harmless if they carried around a large, padded surface to fall onto. They were also much less likely to occur when it would put them in a truly life-threatening situation - I.e. while driving - because their brains knew enough not to have one during that time. I'm not saying it's safe to let them drive, but it might be why some docs are OK with signing off on permission to drive. 

That is really interesting! It sort of seems like there can be a 'behavioral' component to the episodes, but I do not want to dismiss the severity or authenticity of the diagnosis. 

The staff member told me a disability claim was denied, and perhaps that is part of the thought process? It is such a confusing condition, and a lot of the resources I have looked at seem to treat it as attention-seeking. 

Either way, I wouldn't want to be on the road while this person was driving. 

Specializes in School Nurse. Having conversations with littles..
seedanurse said:

Our school district does not have a nursing supervisor/director and I am not aware of any state level supervision for school nurses.  

Is that someone you contact through the board of nursing or board of education? 

In Missouri she works for the Missouri Department of Health.

Specializes in kids.

Possibly the School Nurse consultant?

+ Add a Comment