Quick Nursing Tip : “Seizures” and Drama

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Jazz Kitty SchizophreniaI’ll offer none of the standard nurse education about Grand Mal seizures in this post. I have something rather different in mind.

Patients have seizures, some more often than others. Some patients also fake seizures to garner attention and build drama: so-called pseudoseizures. I’ve met many people with real seizure disorders who also offer pseudoseizures. It pays to know how to deal with this behavior effectively.

First off, assessment. Nursing process, right? Few people, even those with seizure histories, know how to plausibly fake a generalized seizure. They may know to lay on the ground, close their eyes and thrash their limbs: that’s all obvious and easy. Most people fail in that their “random” movements, on assessment, are coordinated and therefore clearly voluntary. Muscle activity in a seizure is random: no back and forth, no bicycle legs, none of that: random. Most people can’t pull that act off well. They’re also not apt to fake incontinence, for obvious reasons.

Second, your response: your goal is to cut the odds of it happening again, as these events waste your time and often frighten others. They’re also a bad habit: an ineffective way of engaging other human beings that we’d like to replace with something more useful and healthy. That all said:

Offer no drama: act calm, unfazed, quiet. No running around or yelling for vital signs or whatever. Don’t make the experience entertaining for them. Make it BORING.

Don’t shame the person! It doesn’t matter if they deserve it or not. The point of all this intervention is to improve your future and your patient’s future. If you embarrass them in public, you’ll pay a price for such unkindness in resentment, further misbehavior and drama, poor rapport and poor cooperation. Why make life harder that way? Kindness pays, and it’s the right thing to do. It works best.

Instead, whisper so only the patient can hear: “It’s not as easy to fake a seizure as you think,” or something equivalent. Make you no one else can hear you. Offer to help them up when they’re ready. Show absolutely no anger or resentment: flat, deadpan, quiet, monotone works best. Then, watch and wait, silently. If your assessment is correct, it will soon stop, and it will not happen again. No fun!

Victory!

The best argument is the one you don’t engage in, as Dale Carnegie wisely pointed out a century ago. Use your head, focus on desired results and do what it takes to achieve them. Trust me, it’s a far better than saying whatever angry thought comes to mind naturally, as most people do, and can save you lots of time and frustration.

Skills make any job easier. Nursing is no exception. People skills, especially so.

11 comments

  1. I for some reason (maybe an early sign of my cancer?) had a few petite mal seizures and only one grand mal, right in from of a triage nurse as I was going because of the petite mal seizures. I was sped back (don’t remember it, but apparently, they freaked) came to eventually, and got some anti-convulsants via IV (painful!!!). Then they prescribed me Depakote and pulled my driver’s license. It was gone for 6 months after I phased off the meds and it was such a hassle. I really feel for anybody who would be hurting so much they would go through everything that horrible to fake them.

    Liked by 1 person

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