I am still reeling from it. I have heard of these cases but never seen one up close. The pt has had a long struggle with a mysterious condition that no one could figure out. He was the nicest man. Everyone felt very sorry for his health struggles. just very shocking how anyone can do this to themselves. It would be so incredibly painful. Until he was presented with the evidence (they searched the room and founds lots of it!) he denied everything and acted like he didn't know what they were talking about. He just had a drastic, disabling surgery today because of the injuries he caused. His family is devastated. His nurses are hurt and angry. Just so many feelings.
There was a case on my on-line tube-feeding support board (I am the parent of a tube-feeder) that also caused waves. A little girl severely underweight, multiple GI surgeries, central line, TPN, catheter, who knows what else. She was arrested for putting feces into all her daughter's tubes and wounds. The girl had all the tubes removed and started eating and growing finally, but will be physically and emotionally scarred for life. Ugh.
But to see it today for real, the shocking injuries that were self-inflicted over and over again, his family crying so hard to learn what's been going on. It's going to take me awhile to get over this.
It is one thing to read about it in textbooks, but to be confronted with it is entirely different. I myself had not cared for the pt for the weeks he had been on the floor (I'm just as student nurse), but the other nurses grew to care for him and his family were very shocked by the degree of manipulation that occurred. He was very very smart and calculated about it, and had obviously done research into how he could deceive the medical community in creating these conditions. If you are human, you will create bonds with people in the act of compassionate nursing and he was one that many liked on the floor.
A pt who suffers from dementia or depression or other types of mental illness, their actions are not usually intentional and don't try to manipulate others in such a deliberate manner. I have seen pt try to manipulate (and usually they are just lonely or very needy or have drug dependencies). It's not our job to judge them, but to take them as they are and treat their conditions and try to get them better. But I've never seen anything like this-- this was in a class of its own! I have been reading up on this condition and it seems to be related to borderline personality disorder which is a really tough one to treat.
I feel very very sorry for the pt's family. I am having a hard time feeling sorry for the pt. per say, except that it's very sad that a person feels they need to do this. He is now being treated by the psych people as is appropriate. It's just a hard thing to wrap my mind around.
You said how you feel, that is why we come here, OK by me.
Have actually never met 1 or experienced such a thing. I can't imagine how that feels. It is probably easier to be said then done when we say "let's be compassionate, try to understand, and move on." But consider that it's really all you can do. When you do this, it's really more for you than them. No one who hasn't suffered from it will really "get it". And you would drive yourself crazy contemplating that kind of craziness for long. To be an effective practicing nurse, you have to be able to move on...or you'll soon get stuck.
And people contribute to their own illnesses ALL THE TIME. Both physical and mental illnesses, so many lifestyle decisions affect health yet knowledgeable, intelligent, high functioning people make poor decisions that lead to health issues every day. I think it is part of the vulnerability of being human.
Mental illness comes in many different shapes and forms, it crosses ages, socio-economic status, evertying. Many, many people with mental illness appear to be functioning very well in life. They are able to keep their illness and the dysfunction it causes to one domain or one area...although in crisis it may spill over into other domains.
Very true on both points!
Yes, a vast majority of the problems I have seen so far in clinicals in acute care come from lifestyle issues-- smoking, obesity, drinking, etc. I know it's complex and not just a matter of quitting those things. You have to consider education level, resources, social issues (if everyone in the family smokes then that's their norm), and so on. And yes, mental illness. I have seen people who have such low self esteem or poor choices (stuck in poverty or whatever) that they have no reason in their own mind to improve their lives. It's all so sad.
To be an effective practicing nurse, you have to be able to move on...or you'll soon get stuck.
Totally. I feel better just venting about it and getting some input. It's not something I can just call my best friend about, KWIM? I need to start studying for that pharm exam now . . .
Ouch! Muchausen's syndrome is a mental illness. Would you make that same statement about someone with bipolar or schizophrenia or addiction? It's an illness in he same way that congestive heart failure, diabetes, and hypertension are illnesses. It's *not* a character flaw. I understand how upset one would be when it's Munchausen by proxy--I'm a peds nurse, I've seen it myself. But when we delve into the "they're evil and deserve to be punished" pot we're kinda painting the "stuff" on ourselves.
People with hypertension don't inject children with toxins, don't feed them mild poisons, don't inflict unnecessary surgeries on them, don't deprive them of health and sometimes life.
I have a problem with someone who is not insane, in the way that, say, Andrea Yates is, deliberately torturing a child to feed his/her own twisted need for attention. Neurosis is not psychosis.
They're bad people. One CAN be mentally ill and bad.
You said how you feel, that is why we come here, OK by me.
One other word of caution, I have unloaded stories like this here also. I always change details like sex, age and type of hospital so that no one would recognize themselves. Hope you do that too.
I myself had not cared for the pt for the weeks he had been on the floor (I'm just as student nurse), but the other nurses grew to care for him and his family were very shocked by the degree of manipulation that occurred. He was very very smart and calculated about it, and had obviously done research into how he could deceive the medical community in creating these conditions. If you are human, you will create bonds with people in the act of compassionate nursing and he was one that many liked on the floor.
I don't understand the anger directed at him. It's not as if anything he did was personal, done just to spite any of you or to make you look foolish. He was driven to behave this way by a mental illness. You sound as though you/the other nurses are mad because you got played, when that's not the case at all -- you all treated the symptoms of a disease with care and compassion. It just wasn't the physical disease(s) you assumed he had.
I don't understand the anger directed at him. It's not as if anything he did was personal, done just to spite any of you or to make you look foolish. He was driven to behave this way by a mental illness. You sound as though you/the other nurses are mad because you got played, when that's not the case at all -- you all treated the symptoms of a disease with care and compassion. It just wasn't the physical disease(s) you assumed he had.
I think it was frustration more than anger now that I think about it. You want a person to get better or at least be comfortable, and no one could help this person. I think that's what's frustrating about psych nursing-- I hear my friends who work there talk about how it's just really really hard to help a person in any way, even with small comfort measures much less cure them. They don't realize you are trying to help, they are stuck in their own world and it's a sad and scary one. At least (in my limited experience) with most patients you can comfort them in small ways, take care of a good part of their pain and they realize on some level (not always of course but most of the time) that you are trying to help them.
I had a patient who was suspected to have Munchausen's and I get the frustration you are speaking of. He was very histrionic and had multiple invasive surgeries that could find nothing wrong. I had him postop for two of the surgeries and he always complained of pain way above the proportion of the surgery (no drug hx). Of course we treated for pain and I never treated him differently but inside I did feel a twinge of frustration.
Having cared for psychiatric patients for almost a decade before becoming a nurse, I was disheartened by the judgments expressed in this thread. I'm glad the poster indicated (later on) that she was a student. The lack of experience in the field truly shows, based on the ignorance associated with psychiatric illness and psych nursing. Perhaps some of the others should identify their own educational limitations and lack of experience in the field as they are also discussing their inability to show compassion for illnesses they don't like or comprehend. Attitudes like these, from professional nurses especially, are the primary reason why the stigma against the mentally ill persists. I wouldn't condemn them to hell, just like I can't condemn obese people to hell for eating themselves into a knee replacement.
Having cared for psychiatric patients for almost a decade before becoming a nurse, I was disheartened by the judgments expressed in this thread. I'm glad the poster indicated (later on) that she was a student. The lack of experience in the field truly shows, based on the ignorance associated with psychiatric illness and psych nursing. Perhaps some of the others should identify their own educational limitations and lack of experience in the field as they are also discussing their inability to show compassion for illnesses they don't like or comprehend. Attitudes like these, from professional nurses especially, are the primary reason why the stigma against the mentally ill persists. I wouldn't condemn them to hell, just like I can't condemn obese people to hell for eating themselves into a knee replacement.
Your post is presumptuous. I deal with the mantally ill every day, some organically caused, some self-inflicted as in Korsakoff's, my sister has schizophrenia, and I battle depression.
I find it astonishing that you can not accept the simple premise that mentally ill people do know right from wrong. Jeffrey Dahmer was mentally ill. He was still a bad person.
I can't imagine how difficult/frustrating it must be to take care of a patient like this. I also think it's ok to express negative feelings about the patient...they're just feelings. We're human, after all. That's why we have a place like this..so we can express our feelings, vent a little, and not be judged. Negative feelings don't mean that we'll give poor care. As professionals we can separate what we feel from what we actually do.
oramar
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