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.
to the OP -it is frustrating and it is a bit sad to see someone willing to take such drastic steps to keep themselves ill. I once had a patient that was severely injured in an accident. His injuries were painful and he was getting frustrated by his incapacitation. Imagine our surprise when we caught him complicating his injuries and extending his illness by taking feces and rubbing it into his abdominal incision. He has already come through several bouts and resurgences of infection in his wounds (including several transfers in and out of the hospital to the rehab ctr).
What I am trying to say here is that you will encounter this type of behavior repeatedly in your career. Don't take it personal. Don't beat yourself up for not picking it up right away. Often the people with munchausen are covering tracks and laying groundwork for things that they haven't even embarked upon medically speaking. Have patience with them as well as yourself.
To those of you who were supportive and helped me to think through this, I really appreciate it. :-) I think I just had to process it, reflect on it, and decide how I would handle this in the future with patients of mine who did this kind of thing. I was kinda in shock when I started the thread but since then I have calmed down and been able to think more clearly.
We are studying the stages of grief/coping and I think some of the nurses (and me) were going through those. When I left many were still in the "anger" stage, some had passed through to the acceptance stage, some were sad for the man and his family. As professionals they have probably seen more than I have, but even then, this pt was a once in a lifetime deal they were saying. It was not the fact that he had this condition, it was the degree to which he was causing harm. It went beyond the usual ones you read about involving fecal matter or picking at wounds. I can't go into details, but it was just shocking. Also, to think a person is being a rational, calm, friendly patient, and then to realize they are very irrational, you wonder how could you have not known? What did you miss? The nurses all realized they saw clues of this before but they were explained away by the patient and they seemed to make sense at the time because those things sometimes happen. The degree of deception was also shocking. This person was very educated on how to create the health conditions and it was complex, and if they had not found direct evidence of it, it would have been hard to believe.
Anyway, I'm ready to move on. Thanks again for providing a forum where I can vent my feelings and get feedback.
To those who expressed strong opinions-- don't judge me. I'm new at this. Even the seasoned nurses were having strong reactions. Don't assume we won't treat the person with the same professionalism that any patient deserves, regardless of if they treat us badly or show gratitude. I was the mother of a sick baby, and I had PPD, and when she was in the hospital I was dealing with a lot of emotions and was not always kind to the staff. I am grateful to those who did not take it personally. And in the same way I can't take this patient's actions personally. He's in his own private hell and that's a tragedy.
Wow! this topic packs a lot of varied emotions. I think the stigma of mental illness is the elephant in the room right now. It actually brings to debate how far mental illness can be used as an "excuse." It somehow doesn't seem wildly debatable to me. take for example a person who is about to end their own life- in that moment the person has a sense of clarity and greater understanding. They have come to a place that has no more options. To come to this end point, it would seem the person is having a "mental crisis", and has become too clouded to see a better solution. It seems to me that the same would apply with most classified, mental illness. Isn't Postpartum another example? I just strongly feel these humans would not choose these solutions, had not mental illness contorted their normal thinking. This is why I made mention to the notion that a person is evil. These acts, especially when made against another human are indeed sick, tragic, and inexplicable. I don't feel they are excusable... but only point out our lack of better understanding; why we need to study with greater depth the workings of our psyche.
I do realize that purpose for the forums is to talk openly about our experiences and feelings around those. Nursing is an emotional occupation inherently, and student nursing is hard business, so much coming in and new. It is also difficult to imagine fully any scenario as much is lost in translation and each of us perceive differently when reading a thing. These forums are a great way to communicate but not the same as sitting over a cup of coffee together!
Why is it so hard to accept that some people are just evil? Oddly enough that wasn't all that clear to me until I became a nurse and realized that some people are just that way. Does that mean I treat them differently or that they don't deserve treatment? No, but I'm human and I recognize that there are some of my (human) race who are fundamentally bad and that is just a fact of life. As a nurse I strive to give equality of care and I think I succeed, and that's what counts.
OP, you will encounter many situations like this in your career and its always sad and always makes you a little more cynical. The trick is to not let it make you permanently cynical, treat every patient with care and vent about the ones who are bad when you need to.
I do not have trouble accepting that some of our race are evil- I object to the term, when it is used connected to mental illness. Again.., I do maintain a person who commits an act against another human or creature, -should- be held accountable. More so, those who are fully aware of the acts they commit, and do so without care, are evil in my opinion. And those who breed hurt and pain, by carrying on warped views that are harmful to other races or lifestyles. I simply hold; mental illness is a disease that one would not choose. Although the definition of Evil does basically translate to: a way of being that is brought on by Satan.. the person who suffers with mental illness likely feels that way, as most try to explain the thing they have done and it sounds evil and without care. (insane) infact...
This topic is a loop- we can agree to disagree. -Cheers :)
I heard about the mother who was putting feces in her daughter's feeding tube but the story I read said the mother did NOT have Munchausen's but was intentionally trying to KILL her daughter to be rid of the "burden".
Most people who have Munchausen's are very sick and do it for attention. But, we must keep in mind that they ARE sick.
Boy howdy, I can't wait until kid molesters get a diagnosis of "inappropriate child sexual attraction disorder" in the next issue of the DSM-whatever. Until then I'm glad they're locked up in prison, hopefully getting a taste of their own medicine. But I'm looking forward to all the lectures us non-crazy people will get about being "judgemental" towards perverts and chomos.
Okay! Listen carefully, class
1)People who HAVE THOUGHTS about munchausening their kids are sick.
2)People who ACTUALLY HARM their kids, for whatever reason, are evil.
They have not been diagnosed as such ( child molesters ) I mean, As far as perverts go each case would have to be considered individually, So that's not so relevant to this point, if that happens, I will then reconsider my feelings on the topic. I actually had no idea of what chomos means, I did find that term in the Urban dictionary, I understand what you are saying, and I know many people feel the same way you do. I am not totally getting the Molester, pervert connection, in reference to anything I have talked about. Okay, I do understand hypothetically...
I know this is going to court controversy and make me unpopular and apologise to the op from detracting from her original posting but feel the need to say the following.....
For some time I have been reading posts as a guest I am always interested to learn something new and the content of many posts interests me. Recently I decided to head in and began posting .... Here's the problem!!... when I read posts like this that turn in to a you said, I said battle I almost squirm in my chair. It makes people like me think best keep quiet as don't really want to put myself in the firing line for what can become a personal attack.
I know and understand that this is an emotive subject and that people will have strong views but that doesn't mean one group is wrong and one is right is just means we see things differently - and that is fantastic and instead of shouting a differing view down it would be nice if we could listen.
I know that by saying the above I have placed myself firmly in the firing line but just want to give a nudge to the stronger characters to say sometimes you can be scarey!! :)
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Flare, ASN, BSN
4,431 Posts
to the OP -it is frustrating and it is a bit sad to see someone willing to take such drastic steps to keep themselves ill. I once had a patient that was severely injured in an accident. His injuries were painful and he was getting frustrated by his incapacitation. Imagine our surprise when we caught him complicating his injuries and extending his illness by taking feces and rubbing it into his abdominal incision. He has already come through several bouts and resurgences of infection in his wounds (including several transfers in and out of the hospital to the rehab ctr).
What I am trying to say here is that you will encounter this type of behavior repeatedly in your career. Don't take it personal. Don't beat yourself up for not picking it up right away. Often the people with munchausen are covering tracks and laying groundwork for things that they haven't even embarked upon medically speaking. Have patience with them as well as yourself.