The effects of a suspected case of Munchausen's syndrome by proxy on a pediatric nursing staff.

Munchausen's syndrome by proxy is a relatively new diagnosis for a unique form of child abuse that involves a parent who creates or feigns illness in his or her child, and presents a "sick child" to the medical profession for assessment and treatment. Typically, while creating or feigning the child's illness, the parent usually appears to be "ideal" (i.e., especially attentive, caring, supportive, and close to the medical staff). The present study assessed the effects of a suspected case of Munchausen's syndrome by proxy on 20 pediatric nurses in a large midwestern children's hospital. After the child had left the hospital, the staff was given a ten-item open-ended questionnaire covering how they felt about the case, how the case affected their interactions with other parents, and how they professionally and personally coped with the physician's presumptive diagnosis. Only 10% of the staff had had previous experience with such a case, and 55% had not even heard of such a diagnosis. More than 70% of the staff felt they were professionally and personally unprepared for the case. Their initial reaction to the suspected diagnosis ranged from shock and disbelief to nausea and anger. The majority of the staff had perceived the parent as supportive, loving, and concerned. Yet, now they were confronted with information that suggested that the parent had nearly killed the child while on the unit, in order to keep that child in the hospital. Although almost every nurse eventually accepted the diagnosis, they felt their relationships with parents in general had changed.(ABSTRACT TRUNCATED AT 250 WORDS)