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.
I think it should be pointed out for those of you who have come to this thread more recently that the OP has changed her original post significantly and has removed the information and stigmatizing language that was being responded to in early comments.
I'm not sayign this is a bad thing. Based on her more recent posts and the new first post she has now put up, I think the OP has gained some insight from this thread and has a less stigmatized perspective on mental illness.
Why is it so hard to accept that some people are just evil?
Some people are evil, but I do not believe someone with Munschausens -- who engages in purely self-destructive behavior -- is evil, even if that person goes to great lengths to hide their self-destructive behavior from others.
(This is going to get me in a lot of trouble.)
It seems to me that the Munschausen patient's (again, not by proxy, just Munschausen) behaviors are similar to those of bulimics and anorexics: both engage in self-destructive behavior; painstakingly research "better" ways of carrying out those behaviors ; and often actively work to keep themselves from getting well, including doing everything possible to keep their caregivers from discovering that they are continuing to deliberately make themselves sick.
Are these people frustrating to work with? Of course. But they're not evil.
Some people are evil, but I do not believe someone with Munschausens -- who engages in purely self-destructive behavior -- is evil, even if that person goes to great lengths to hide their self-destructive behavior from others.
(This is going to get me in a lot of trouble.)
It seems to me that the Munschausen patient's (again, not by proxy, just Munschausen) behaviors are similar to those of bulimics and anorexics: both engage in self-destructive behavior; painstakingly research "better" ways of carrying out those behaviors ; and often actively work to keep themselves from getting well, including doing everything possible to keep their caregivers from discovering that they are continuing to deliberately make themselves sick.
Are these people frustrating to work with? Of course. But they're not evil.
I kind of agree with what your saying. I don't believe that self harming by Munchausens, bulimia, anorexia etc are acts of evil either. I guess you could argue they are hurting others emotionally but they are only putting their own lives and health at risk. To me there is a huge difference between injecting faeces, or starving yourself, and doing it to someone else.
To me an evil person deliberately harms others, quite often those who are unable to defend themselves because they are young, old, physically weaker etc. I have no tolerance towards such people and believe that unless there is some way of altering their behavior then that person needs to be kept apart from others.
This has been an interesting discussion. I'm glad that the OP is feeling better about the situation. It sounds like this man needs a lot of help.
If your a student this is a good lesson in remaining objective. It's not easy. In school they say " if a patient comes in who suffered a domestic assault and she or he is your patient. As a nurse you need to provide the same care towards the abuser if warranted" It not easy. However,in your particular casethat patient becomes a psych patient who also needs physical care.
I had to learn this particular lesson while I was a cna.
I work 3-11. At 10pm one of the nurses had to admit an attempted suicide,apparently she has done this many times. They begged me to stay and work a double because she required constant observation. I caved and said yes. She was a piece of work. She punched the nurse and was verbally abusive all night. It would not have been so bad if she was in a private room but there was another patient in the room and she was sick. I think it was 5am when the charcoal was ready to come out. She looked me directly in the eye, picked up the bed pan and dumped it on the floor. I snapped and told her the next time you try to kill yourself, I hope you succeed!!
.I told my instructor during clinical the following week. She seemed very happy about what I did. I was prepared for a completely different reaction. For a second I thought she was nuts, then she "says congratulations, you just had your first lesson in objectivity, How does it feel? Never forget it."
at 10pm one of the nurses had to admit an attempted suicide,apparently she has done this many times. they begged me to stay and work a double because she required constant observation. i caved and said yes. she was a piece of work. she punched the nurse and was verbally abusive all night. it would not have been so bad if she was in a private room but there was another patient in the room and she was sick.
does this mean little miss suicide attempt *wasn't* sick??
i think it was 5am when the charcoal was ready to come out. she looked me directly in the eye, picked up the bed pan and dumped it on the floor. i snapped and told her the next time you try to kill yourself, i hope you succeed!! i told my instructor during clinical the following week. she seemed very happy about what i did. i was prepared for a completely different reaction. for a second i thought she was nuts, then she "says congratulations, you just had your first lesson in objectivity, how does it feel? never forget it."
i don't know whether to be more shocked by you or by your instructor. i know how this girl must have pushed your buttons. people with mental illness can be exasperating. but they are sick, nontheless. i disagree with your teacher--this was not a lesson on objectivety. this girl manipulated you until you lost control. no shame in that--it happens frequently, especially with addicts & alcoholics. but i can't imagine a patient ever pushing me to the point that i would tell them i hope they succeed in killing themself. i am just floored!
eta: as someone who has suffered multiple bouts of mind-breaking depression with suicide attempts, if someone had ever said that to me it would have finished me off.
This condition is not just what most people assume it to be, a cry for attention, it is much more than that. It is a serious psychological condition that this man is suffering from, it is draining on him both physically and mentally and not only does it damage his emotions and his mental state but also causes him to cause much damage to his own health and well being and his body all together. These people are not just drama queens that want a little attention, they can't help what they do, it is like they are posessed somehow to do these things and they don't feel right until they are doing it. He needs plenty of help from a professional with knowledge, training and experience in this field, without it you will be seeing him more and more, you can't turn these people away just because they caused it themselves, yes you may be frustrated to learn that he did it himself but at the same time, have compassion, think about how hard it must have been for him to do it, think about what caused him to do it in the first place. I'm sure he didn't do it because he got any fun out of it.
Munchhausen's and Munchhausen's by proxy are both weird subsets of conversion disorders, when a patient deals with overwhelming stress by converting it into physical symptoms. The difference between Munchhausen's and the garden variety conversion disorder (which is really quite rare) is that Munchhausen's patients make themselves or someone else sick. I've seen all three in a career that was longer than I want to admit to.
The only way they have of dealing with the stress in their lives is by converting it into a physical symptom so they have something to worry about that someone will help them with. Doctors often get infuriated with these patients because they feel deceived and manipulated and are particularly outraged when they cause real harm to themselves or others.
It's really tempting to become furious when they injure someone else, like a child or a dependent elderly person, but it's counterproductive. While you want to remove people from their care immediately or remove their means of hurting themselves, being judgmental and punitive does no one any good.
It can be treated. Different strategies for dealing with stress can be taught.
The only way they have of dealing with the stress in their lives is by converting it into a physical symptom so they have something to worry about that someone will help them with. Doctors often get infuriated with these patients because they feel deceived and manipulated and are particularly outraged when they cause real harm to themselves or others.
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.
Because, legitimate illness or not, it is different when you cause other people harm. Pychopathy is a mental disease, but if you rape and murder 9 woman because of it, then you are scum. I know you understand the difference. Please do not pretend to be naive under the guise of understanding or political correctness.
I stopped going to church because I became sickened by the way my fellow Christians were slamming each other constantly. I'm a pre-nursing student now -- I wonder if I'm stepping into more of the same if i get into the nursing world. (Should I change majors at the age of 47?) Or is there another site that is more supportive of each other?
I think alot of it has to do with misinterpretting intentions d/t the whole computer versus face to face thing. and also keep in mind that people often act out more behind a computer than in the real world because you are free from realistic retribution, so to say. Dont give up on nursing. This is where people come to vent and voice strong and often differing opinions. Health care is complicated so controversial discussions tend to arise easily.
i don't know whether to be more shocked by you or by your instructor. i know how this girl must have pushed your buttons. people with mental illness can be exasperating. but they are sick, nontheless. i disagree with your teacher--this was not a lesson on objectivety. this girl manipulated you until you lost control. no shame in that--it happens frequently, especially with addicts & alcoholics. but i can't imagine a patient ever pushing me to the point that i would tell them i hope they succeed in killing themself. i am just floored!
Meraki
188 Posts
I think it should be pointed out for those of you who have come to this thread more recently that the OP has changed her original post significantly and has removed the information and stigmatizing language that was being responded to in early comments.
I'm not sayign this is a bad thing. Based on her more recent posts and the new first post she has now put up, I think the OP has gained some insight from this thread and has a less stigmatized perspective on mental illness.