Gastro Disastro

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Gastro Disastro

"I once had a young person fake a gastrointestinal bleed. They went to the ER with a picture of blood in a toilet saying they threw up a lot of blood. We immediately put two IVs in each inner elbow and started working them up.

They said they have to go to the bathroom and, and we allowed them to walk in there because they still seemed strong enough. They came back out and say they threw up again. Blood was everywhere.

They were whisked away to the ICU (my unit) for immediate intervention due to the amount of blood that had been visualized. Then they had a unit of blood transfused without checking their blood count again to stay ahead of the gross loss of blood.

They threw up in the bathroom again with the same bloody show. Though they weren't pale and were still strong, plus their blood pressure was still good, so we figured that since they were young, they could handle more before showing signs of deterioration.

Then they were sedated and intubated (to protect the airway if their bleeding is that bad) and an endoscopy was performed to find and stop the bleeding. It looked perfect. Nothing was seen and we went down with the scope a second time just to be sure.

The gastro doctor said there seems to be no bleeding and didn't know what to make of it. Everyone was confused. The nurse started trying to figure out why and found an empty, bloody syringe in the patient's pocket while they are still out cold.

This person took a saline flush, emptied it, and used it to draw up blood from their IV, then proceeded to squirt it all over the bathroom to fake throwing up blood. Even squirted some in their mouth the second time to really sell it. Patient's significant other said they'd been a pill seeker before, and that they would stay as long as we gave them pills.

We removed both IVs before they woke up. Then we explained nothing was found and they were perfectly fine, but we did find the syringe. The patient got angry and said they're gonna leave. That's fine, sign this form (your insurance might not pay now), and we'll call you a cab and pay for it because you're still recovering from being fully sedated and intubated for that endoscopy.

The patient denied a cab and walked home with no cell phone or wallet (because their significant other had abandoned them as soon as we explained the patient was not bleeding). Not sure how long they had to walk or how far they got, but they just went for it."

They Were Afraid They Had An Epidemic On Their Hands
They Were Afraid They Had An Epidemic On Their Hands

"I was in prison healthcare and every morning the prisoners would get a chance to move freely around the prison to go to their workplace, or visit us if they are on daily meds or something.

Often if people are unwell, they will come to healthcare and get a sick note so they can get a day off work without being penalized. Well, one day about 30-40 guys turned up at our healthcare window complaining of headaches, stomach aches, and a few claiming to have vomited, although no confirmation from any of the officers.

The strangest part was that every single one of them was from the same prison wing, so we put in a security report saying that we were worried something fishy was going on.

It turned out that one of the guys in that wing had family appearing on the Jeremy Kyle Show (UK's version of Jerry Springer) and all the guys wanted to stay in their cells and watch it! However, their cunning ruse to skip work turned out to be unnecessary as one of the officers on the wing had recorded it for them and played it back during their social time."

"Stop That!"

"I've seen patients faking seizures, but one guy took it to the next level. Arms and legs shaking, not the head or torso. It looked more like a rain dance than a seizure. He was talking through it! Neuro doc happened to be close by and came into the room when we called for him.
'Stop that,' he said.
'I can't!' the patient replied.
Doc put his hands on the patient's legs, hard and firm, and said, 'STOP.' The patient immediately stopped."

She's Got A Secret
She's Got A Secret

"I was working in an antenatal clinic when a fifteen year old girl, her fifteen year old boyfriend, and his mother came in for an initial appointment.

The first appointment always involves sourcing as much history information as possible, setting up an initial plan, and then checking that the baby's heartbeat is tracking as expected.

The family was very friendly and the pregnancy was obviously unplanned. His family had taken the young girl in and she looked very uncomfortable. The boy was daunted, but doing his best to be involved.

When we got to checking the heartbeat, I wasn't able to find anything. The midwife with me couldn't either. We were concerned she may have miscarried, so we brought in the most experienced midwife to check.

We had been treating this as a purely medical issue, until both the supervising midwife and I took a step back and noticed that while the boy and his mother were distraught, the girl was looking more ashamed than anything else. It was the first indication that something wasn't right.

As a group, they all went up to see the doctors in another building. The next morning I found out that after an hour with the doctors, she confessed that she had made it all up so she could move to Australia with her boyfriend."

You Cannot Possibly Be The Father

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You Cannot Possibly Be The Father

"We had a lady who would come in every few weeks with a new guy claiming she was in labor or experiencing a miscarriage. Of course, we had to take her seriously every time even though we knew she wasn't, so we'd scan her, etc, only to tell her that she's not pregnant and isn't experiencing labor or a miscarriage.

She'd then turn to her guy and say that modern medicine is unreliable and he should just trust her instinct, and help her raise the baby. The guy would often become afraid, 'How am I gonna raise this baby? What are the chances a scan is wrong?' Etc.

We'd reassure him that she is 100% not pregnant, they'd argue, break up, and she'd be back a few weeks later. Also, she'd come in by ambulance. Every time. This is in the UK where we have free healthcare, so she wasn't paying a penny for any of this."

She Couldn't Believe Her Eyes When She Came Back In The Room

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She Couldn't Believe Her Eyes When She Came Back In The Room

"The patient was a man with a fistula (hole from skin to organ) that had copious output, created by the man picking at an incision site. He had a controlled substance alert, and was continuing to request his oxy every four hours on the dot (which I gave because abdominal wounds are painful), and also requesting IV Dilaudid.

When I told him that I wasn't going to be giving him the IV Dilaudid, he was very upset and tried to manipulate me into changing my mind, but I didn't cave. Later, I entered the room to see him happily picking at and extruding his own bowels.

The ostomy bag that was catching the output was completely filled with blood. The first thing he requested when I entered was the IV Dilaudid. Probably one of the grossest things I've ever seen in the hospital."

Jacked Up Junkie
Jacked Up Junkie

"I once had a lady who'd maxed out her fentanyl scripts and other meds. She did have a legitimate issue, but she'd also become a full-blown prescription addict.

She agreed to be admitted to the hospital under the pain management team for a horse tranquilizer infusion, with supplemental morphine and diazepam to help with withdrawals (the horse tranquilizer is thought to 'reset' things so the patient can make do with fewer narcotics).

The only problem was, she had psychological issues as well, and was basically babied along for four weeks. The number of pills she was still on was spectacular. No one specialty would take control, and nobody wanted to deal with it.

When I'd go in there, she would rate all her scores high and pretend to have the shakes. No lady, wiggling like a worm is not a withdrawal symptom (And yes, I have dealt with a lot of people in withdrawal).

Then she got another pain patient in with her, and despite me bringing my concern to light, they remained roomed together. Of course, they egged each other on, and things escalated.

The second day, before I got to work, the patient had gone on a walkabout with her horse tranquilizer drip. She claimed to not remember doing it but after I got to work she told me she might do it again. The head nurse wanted her moved closer to the nurse's desk so she could be observed.

Of course, she didn't like that and threw an epic tantrum. She was over 50 and some of the highlights included ripping her IV out and spraying blood all over her fresh white blanket, sitting on the ground, and smacking her head against the cupboard.

I honestly wasn't fussed. It was all for show, but I took her sharps out of her bag for good measure. She did eventually settle down and after a week was fully detoxed. I met her in another ward a few months later and she was a different lady, having a normal level of pain meds for the procedure she just had, and finding them effective. I don't know if she remembered me or not, but we both acted like we just met each other.

This particular hospital had the best pain clinic attached to it, bar none, with excellent support from a multidisciplinary team. She was never going to be just cut loose. However, that behavior needed addressing to just get her detoxed- which she'd chosen. Until it was, she was getting nowhere.

Also, I bear no grudges on how people behave in hospital. I see them at literally the worst time of their lives. It always amazes me how good most people are. If they're not, well, I do my best to find out what's causing the problems."

Her Grieving Relatives Didn't Stop Her From Stealing The Show
Her Grieving Relatives Didn't Stop Her From Stealing The Show

"This one was actually a patient's family member. The family was grieving in the room since the patient was on comfort care and not expected to survive the day. A niece of the patient, who was easily in her 30's, started screaming like she was being murdered and fell to the floor near our nursing pod.

She started convulsing, but her family completely ignored her. Some even sidestepped her or literally stepped over her while trying to leave the unit. The niece would randomly convulse while we were loading her onto a stretcher.

The charge nurse picked this lady's arm up and let it fall. It somehow just softly returned to her side. Finally, she was loaded up and we were ready to transport her to the ER. The lady's relatives? They simply asked if the hospital was going to pay for her tests.

The doctor said no and miraculously the niece shot up and acted like she couldn't remember what happened. The rest of the family just left her there and told the desk not to let her back into the unit once she was escorted out."

It's A Miracle!
It's A Miracle!

"I think the most annoying faker was this woman who would just stay in bed all day. She wouldn't even try to get up. She actually liked being catherized.

She would also take notes while talking to nurses, doctors, and other allied health professionals while claiming to be a lawyer. She did some clerical work for a law firm, I later found out.

She always needed pain medication (legit) and would get them on the dot (every six hours). She would complain constantly and be very irritating.

Then I got a social worker involved, who said that she had to leave the hospital soon. Since she was not able to walk or complete any activities of daily living, she must be transferred to a nursing home as soon as possible.

She magically got out of bed and began to walk with a walker. With a little bit of help (not even intensive rehab), she was walking and doing everything herself within a week. Two weeks later she went home. What a medical marvel!"

He Was So Over The Top, The Doctors Knew Something Was Up

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He Was So Over The Top, The Doctors Knew Something Was Up

"I once had a patient who claimed to have intractable back pain, was 'not able to walk' (despite having an intact neurological exam), was moaning and groaning to an extent that was completely unreasonable, and was otherwise extremely dramatic and pretending to be completely handicapped.

He had been on workers' comp for a good year at that point and claimed his back pain made it impossible to work. I started making some small talk about sports-related injuries in the waiting room, then asked if he played any sports. He replied that he played hockey.

I steered the conversation away towards something else, then casually asked him if he had been playing this winter. 'Yeah, I played yesterday in the rec league and we won!' I documented the comment and sent it to the workers' comp board on the spot. Of course, I didn't mention it to him. He didn't even notice what he'd said."

The Ol' Bait And Switch
The Ol' Bait And Switch

"One day, I have several patients to see. I'm informed that my priority patient is an elderly woman who came into the hospital with severe chest pain. I haul to the coronary care united to assess her, start the exam, and ask her about her chest pain.

'Hmm? Oh, I'm not having any more chest pain. But let me tell you about this toe here on my right foot, just giving me fits, it started in October and I thought it might be a change in the weather...' She literally faked a heart attack so she could get admitted to the hospital because she wanted someone to look at her toe.

They'd already run tests on her before I arrived, and everything was negative, but she was ancient and had chest pain. At this particular hospital, we got a lot of 'this patient is totally stable, but we fear litigation, so let's admit them to a critical care unit' patients. If you came in with chest pain, if you were in any sort of respiratory distress (even if it was completely resolved in the ER), if you had sniffles and a lactic acid of 2, to CCU you went."

Don't Try This At Home
Don't Try This At Home

"A guy ended up in the operating room from the emergency department with a dislocated shoulder. We were going to reduce it (pop it back in) under sedation. He named both medications that the nurse anesthetist pushed through his IV.

He asked, 'Is that Lidocaine? Is that Propofol?' and didn't seem the type that worked in the medical field, what with the large swastika on his chest, which looked fairly fresh. We put him to sleep, moved his shoulder around under the x-ray, and wouldn't you know, his shoulder was fine.

Apparently addicts with a weak rotator cuff that can easily dislocate use this trick to get their fix and have it 'fixed' in the emergency department. Little did he know the orthopedic surgeon on call decided to take him to surgery and do things the expensive way. He was uninsured, so I'm sure the medical bill was insane."

He Just Had One Very, Very Important Question To Ask
He Just Had One Very, Very Important Question To Ask

"As a resident, I had a patient who had a blood clotting disorder, but who was also addicted to IV pain meds. He figured out how to get admitted for an extensive workup due to a possible blood clot in the lung, and wanted IV pain meds for his 'chest pain.'

He came in all the time, but it was very difficult to block the admission because he actually did have a risk of this problem. He never took his blood thinner correctly and his symptoms always bought him a couple of days at least while we ruled out a clot and got his blood levels where they are supposed to be.

But it meant he had accumulated over 30 high-resolution CT chest scans over his life, which is not good for you. In fact, it's downright lethal. I had one question I would ask people who tended to come in complaining of every serious sounding symptom they could think of: 'Does it ever hurt behind your eyes when you pee?'

I was very salty at that point; this guy was a nightmare when he ended up in your service and it really bothered me that he was admitting himself with a likely fake lung tumor just to get a day's worth of IV pain meds and Benadryl.

With him, I started asking the 'pain behind your eyes when you pee' question like it was extremely important, and he'd quickly answered yes. I acted like it was an extremely serious condition that warranted evaluation.

I consider it one of my greatest achievements in residency, that one day he showed up in the ER with 'pain behind my eyes when I pee' as his chief complaint. Then one day I overheard a colleague talking about this crazy dude who came in demanding to be admitted because he had excruciating urination-related eye pain. Made my day."

Merciless Mother

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Merciless Mother

"Had a mother come in and INSIST that her child had Silver-Russell syndrome. You can go read about it. It's not that easy to fake, as it's a bunch of metabolic conditions mixed with congenital abnormalities.

The kid was small, but not that small (around 6th percentile). He didn't weight much (5th percentile). All of this, with a right arm length 2 cm more than the left side, were borderline criteria for Silver-Russell. Did genetic testing, which came back negative, but 30% of cases are negative.

So the deciding factor was one of the 'soft' criteria, hypoglycemia. Once she heard about this (she printed out 30-40 articles on the disease), she came back with the kid in a coma. But when the kid was in the hospital, he was never hypoglycemic. He went home and came back in a coma a few weeks later. Again, as soon as he was eating normally at the hospital, he was never hypoglycemic.

She starved her child into comas repeatedly for the diagnosis of Silver-Russell. She was also one of those people who live off welfare and make a game out of it. By the way, she was in a wheelchair when at the hospital. Once, I had enough of her bull and walked into the room after only knocking once. She was walking around normally and jumped into the wheelchair as soon as she saw me.

I believe it was for money since in Canada/Quebec, you get money when your child has a genetic disability...God, if it was legal, I would have slapped some sense into that witch. His mother was a downright psychopath. Don't worry, we called the DPJ (Youth Protection)."

How To Tell The Real Deal From The Fakers
How To Tell The Real Deal From The Fakers

"I worked in the ICU and one day, we responded to a stroke on a surgical floor. It was a 60ish-year-old woman who complained of 'not feeling right,' extremity weakness, and slurred speech. We started a neuro exam and asked her to hold up her arms. We had to physically hold them up for her because they'd just flop down.

We tried asking her some questions, but she kept her eyes tightly closed and just mumbled random words. So we started suspecting that she was pulling our leg. That's when we decided to have some fun.

Fakers hate when you ignore them because they're attention seeking. But how do you get attention when you're faking a stroke? Well, the team was talking amongst ourselves, loudly saying, 'Maybe she took something! Let's go through her purse.'

We started opening stuff and finding unidentified pills. When we asked each other what they were, we heard, ever so quietly, 'Gabapentin...Lortab...' Guess who perked up? Little Susie Stroke had one eye open, watching us rummage through her belongings and was helping us identify her meds.

We decided to call it done, took all her meds to the pharmacy to hold, and started walking out. Well, we took one last look in the room, and there she was, sitting up in bed and scrounging through her bag to see what was missing. What a miracle!"

A Special Test For A Special Patient
A Special Test For A Special Patient

"I was responding to a code blue (non-breathing patient on a hospital unit) in the mental health sector. I went there to find the patient on the floor with a bag beside them (it was over their head when found).

They were breathing so no CPR was needed. I attached the heart monitor, and everything seemed ok. Blood pressure good, oxygen levels good, but he didn't open his eyes to pain or anything.

The doctor said, 'Let's do a brain test.'

I had no idea what she was talking about so I said, 'Can you administer the test?'

She said, 'Don't you know how?'

I said, 'No.' She then told me that if you lift their left arm in the air and it stays there, they have severe brain damage because the muscles contract involuntarily to the brain.

At that point, I'm thinking, 'What the heck! This doc is on crack!' But I was like, 'Oh, really?' She then winked, lifted the patient's hand in the air, and it stayed there. She packed up the heart monitor, told the staff on mental health to take away the bags from the unit, and walked out. Maybe 10 minutes after we left, they called a code white on the patient (violent patient code). She must've been really mad that we didn't believe her!"

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