how do you react to patient who either everyday or every other day have a crises where they have a major soamatic complaint where they need to go to the ER (heart attack, appendicisit.....) or they "get mad" at somebody because that person "talked about them"? and then they attack this person who "made them mad by talking about them"? i've asked management for an inservice on attention seekers but haven't got one yet. what is the best way to react to these patients? we don't have the staff to take care of this kind of "drama".
hsieh wrote:how do you react to patient who either everyday or every other day have a crises where they have a major soamatic complaint where they need to go to the ER (heart attack, appendicisit.....) or they "get mad" at somebody because that person "talked about them"? and then they attack this person who "made them mad by talking about them"? i've asked management for an inservice on attention seekers but haven't got one yet. what is the best way to react to these patients? we don't have the staff to take care of this kind of "drama".
This patient sounds like they might have a disorder called Somatization Disorder. Another name for this syndrome is Briquet's Syndrome. Basically it is a psychological problems that is manifested in physical complaints that have no organic basis. Such dysfunctional symptoms tend to range from sensory or motor disability, hypersensitivity to pain. Four major somatoform disorders exist: conversion disorder (also known as hysteria), hypochondriasis, somatization disorder, and somatoform pain disorder.
A good way to deal with this type of patient is to help them find a primary care doctor that is sympathetic, supportive, and willing to help a patient with this disorder. Some doctors will have a person in their office call the patient once or twice a week just to say hello and to check up on them. Spending 10 to 15 minutes once or twice a week can lessen the number of unnecessary trips to the ER. Telling a patient with this disorder that they are "nuts" is counter-productive and they generally reject any suggestions for psychiatric help or counseling.
Here are some links with helpful information:
http://www.schoen-kliniken.de/English/KHB/Somatoform/Discription.htm
http://www.medsci.uu.se/occmed/webkurs/trends/trender.htm
http://www.psychnet-uk.com/dsm_iv/somatization_disorder.htm