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.
They're bad people. One CAN be mentally ill and bad.
IAWTC!
It's all about CHOICES. Just because you are mentally ill does not mean that you cannot make choices it just means your perception of reality is a bit skewed.
My adopted sister struggles with various mental illnesses (stemming from her biological mother drinking while pregnant; Please help people become educated about Fetal Alcohol Syndrome) and she still understands the difference between right and wrong. It is harder for her and she had to deal with things in a different way from others but she also understands that SHE is responsible for HER actions.
Mental illness is a REASON for actions but it should never be used as an EXCUSE.
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.
Actually, the presumption is yours. I absolutely accept that mentally ill people CAN know right from wrong. But I also know that when symptoms are acting up, a cloud develops over the knowledge of "right from wrong." All those illnesses you discuss don't even touch the implications of a Munchausen illness. And just because someone has a hateful illness does not make it ok to hate them. Or condemn them to special levels of hell because of them. I've had to care for mentally ill rapists and pedophiles, and though I despise their actions, I worked with the idea that I could try and help them, rather than banishing them to Dante's seventh circle.
How do you feel when you hear the public misinterpret schizophrenia and imply that your sister should be locked away for being "potentially dangerous"? Just because one mentally ill person was "BAD" does not make all them "bad". The illness does not dictate the personality. I have no doubt that she is more at risk from the public than she is to the public. How offensive is it to hear someone tell you to "cheer up" or "snap out of it" when your depression is acting up? If it were so simple, the need for specialized medications would be nonexistant.
I won't turn this into a debate with you, because I think it's a waste of time trying to argue with someone who chooses to personalize this conversation. But for the record, Dahmer did not have Munchausen (which is actually called Factitious Disorder these days, for anyone interested), so the association to him doesn't make sense to me. But being compassionate to all patients, regardless of their illness, symptoms, or your "moral" judgment, is paramount to the nursing profession. The comments here don't reflect that, and this is the sentiment which I was expressing, and which you find to be "presumptuous". I apologize if that point was unclear.
I also cannot imagine why Nurses and other staff members could possibly feel hurt or angry by this. That sort of ganging up of emotions simply cannot be good for the family or the patient. I am also not convinced that there is a "special place in hell" for those that suffer with mental illness. I'm sure there is a place in a psych ward that would be better suited to their needs. Mental illness in its many forms doesn't present well, that's the nature of the thing. By proxy -is- most disturbing and luckily to our healthy minds seemingly impossible to imagine. We are talking about " illness" maybe not one of the types we are trained to manage, but as health care professionals, isn't it our responsibility to view any illness, as just that?
Isn't THAT where all the sanctimonious, self-righteous professionals 'in the know' gather to impart wisdom and guidance to the rest of us just plain ole worker bees?
You're entitled to your feelings, Chai, and no one else is either required or has any need to "understand" why, when or anything else about it.
See that?
We can be accepting and empathetic to you as a student and, as far as we know, you don't even need to have a mental illness to garner that compassion.
I also cannot imagine why Nurses and other staff members could possibly feel hurt or angry by this. That sort of ganging up of emotions simply cannot be good for the family or the patient. I am also not convinced that there is a "special place in hell" for those that suffer with mental illness. I'm sure there is a place in a psych ward that would be better suited to their needs. Mental illness in its many forms doesn't present well, that's the nature of the thing. By proxy -is- most disturbing and luckily to our healthy minds seemingly impossible to imagine. We are talking about " illness" maybe not one of the types we are trained to manage, but as health care professionals, isn't it our responsibility to view any illness, as just that?
I never said that anyone ganged up on the patient. In fact he was treated with professionalism and dignity both before and after the discovery of his issues. I was very impressed by that. The nurses only talked about the patient in the private briefing room and not anywhere else. Even the sitter today didn't know the history of the patient other than he was at risk for self-harm. He was still a patient with medical problems and deserved the best of care to heal. None of the other patients was aware of the situation and the atmosphere was actually very calm today on the floor. It was just a big shock to everyone and they expressed their feelings in private, and then put on their smiles for the other patients.
I think the root of it is: we must treat everyone the same, but we arent saints and we are entitled to opinions (that we should vent here, but keep to ourselves when with the patient)
To the OP: This is one of those experiences that are hard to deal with but a good opportunity for self reflection. As a nurse your going to be confronted with people from all walks of life, and yes even people who inflict harm on themselves and others. I'm not going to tell you not to be judgmental. At the end of the day we're not automatons with no thoughts and feelings. Of course we're going to have a personal opinion on the actions of others.
I've looked after psych patient in the OR who are prisoners. Anytime someone (usually the surgeon) asks me if I know what he was in prison for I very loudly make it clear that I DON'T WANT TO KNOW!. I don't want to know if my patient is a pedophile animal torture, rapist, someone who harms children bashes old people etc. I'm a nurse, but I'm only human. I don't want to harbour negative and judgmental feelings towards my patient.
Personally I agree with SuesquatchRN about the biproxy. Some people are too dangerous to others to have any place in society and should really be locked up for life. But as a professional we have to be very aware about how our own personal feelings about someone can manifest in our interactions with them. This is why I don't want to know the nitty gritty details. I want to treat everyone the same.
Now I want you to think about this particular patient. He has a condition that you obviously find confronting. Ask yourself, how would you feel if you have a condition that leads to you becoming hospitalized and having to undergo invasive procedures. I don't think any sane and logical person would want to experience this. I would feel pity for such a patient-someone who does it to others well that's a completely different story.
The other day at work a fellow nurse was complaining about her patient, and I gave her a "Well, blahblahblah excuse for their annoying behavior blahblah." Then I told her, of course, if it was my patient, they're just being a pain, but since it's yours, we have to be compassionate.
The compassionate part of me can always find something to excuse whatever it is. But the human trying to get through the day part of me often wants to throttle people!
Munchausen is tough on the medical and nursing staff. You work your butt off trying to fix them, then you find out that all your hard work was in vain, because they "weren't really sick." In reality, you just weren't treating the right illness, but there's still a lot of frustration over all the time you wasted. The staff was duped. It doesn't matter if the person doing the duping couldn't help themselves, it's natural to be mad about it. And those who think we shouldn't be angry need to learn a little bit more about the mental health of caregivers instead of lecturing us to be more compassionate.
And I've got to agree, Munchausen is frustrating. Munchausen by proxy... I'll just say, I don't care how ill you are, you don't get to hurt other people.
Specializes in Peds/outpatient FP,derm,allergy/private duty.
QUOTE=blamejoe;4095870]Having cared for psychiatric patients for almost a decade before becoming a nurse, I was disheartened by the judgments expressed in this thread.
Yeah, me too. It must be really hard to come and express and vent a disheartening clinical experience and be jumped all over by so many people who have worked in psych since the days of Freud. In fact, I looked back through the posts - didn't find a single one that judged the Munchausen man, but 8 who judged the OP, and . . . 7? 8? by the OP explaining and explaining and explaining. Should the nurses be angry and hurt? No, but the fact is when a patient is on a unit a long time, bonds do develop. That's just life in the real world. Maybe they all need a big seminar on psych nursing- but I don't think their reaction as the OP explained is some weird thing from outer space. I seriously doubt the nurses were all leaning on the counter sobbing, "How COULD you???"
Oh, and BTW, John Couey was sick, too. He buried a little girl alive. Richard Allen was sick, too. He left a half-conscious girl in her nightgown to die in the woods. They are bad people. They can go to hel l with the people who put feces in their daughter's feeding tube. Don't tell me I need to stop personalizing this, because I won't. :oornt:
I realise that this thread has raised extremely interesting issues that you feel very passionately about, please can I ask that you discuss and debate to your hearts content, but keep personal comments about individual members out of the thread. We all entitled to your opinions, and we most definitely do not have to agree with each other but we can disagree respectfully.
I have enjoyed reading the input from all members, especially from our psychiatric workers, I have no experiences of mental illness nursing so am completely ignorant, we have a fantastic mental health nurse liaison who supports us general nurses when are struggling which means I tend to hand over to him if I need to.
On a personal note I'd like to think I could be non judgmental if faced with a patient like the OP describes , but then I know that I worry about my patients at home if I can't figure out what's wrong and their not getting better because I care about what happens to them,I think as general nurses we trust what our patients are telling us, I'd have no reason not to and most of my patients have physical causes for their symptoms that can be dealt with.
I can understand the frustation, but not directed at the patient, more directed at my inability to help make things better. I know it's not about me, but my nursing is personal and I guess I would feel I'd failed
That's why I am not a mental health nurse, surgical patents are so much easier to make better
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.
The comments here don't reflect that, and this is the sentiment which I was expressing, and which you find to be "presumptuous". I apologize if that point was unclear.
The first is what I found presumptuous.
Also, I specifically mentioned Munchausen's BY PROXY as being evil and you are choosing to extrapolate from that to all mental illnesses and Munchausen's.
Futher, a "special place in hell" is a colloquialism. It would be hard for me to consign someone to a place I don't believe in.
And, further, should my sister, in a delusional state, harm people, by all means she should be locked away.
OP- I appreciate your thoughtfulness and reflection regarding your clinical experience. If you put that much thought into evaluating your interactions with all your patients, particularly those with complex medical, mental, or social issues, you will be a fantastic nurse.
We all have had those moments. It's okay to be angry, disturbed, and frustrated by patients. What you do with those emotions is what counts. Do you learn more about the disease? Do you evaluate exactly what it was about the situation that triggered such a strong emotional response? Do you seek input from others as to how one should best handle and treat such patients? Do you attempt to understand the mental and emotional aspects of the disease, and how best one treats it acutely as well as chronically? Or do you turn nurse Ratchet on them?
If you answered yes to the first four questions, then you are a good nurse, and recognize that nursing involves constant learning and growth, throughout your career. If you answered yes to the last question, then you do deserve to be raked over the coals in an online forum. It seems to me, though, that no one on this forum answers to the name of Ratchet. If we weren't seeking personal growth and understanding, as well as support and information to improve our practices, we wouldn't be here.
Hushdawg
644 Posts
IAWTC!
It's all about CHOICES. Just because you are mentally ill does not mean that you cannot make choices it just means your perception of reality is a bit skewed.
My adopted sister struggles with various mental illnesses (stemming from her biological mother drinking while pregnant; Please help people become educated about Fetal Alcohol Syndrome) and she still understands the difference between right and wrong. It is harder for her and she had to deal with things in a different way from others but she also understands that SHE is responsible for HER actions.
Mental illness is a REASON for actions but it should never be used as an EXCUSE.