A Presentation of a Curious Nurse Malady: Full Plate Syndrome

This article is the work of a colleague of mine and myself. Since the demise of the journal of jocularity there is not a good place to send this for publication, but we thought we would share anyway.  Perhaps you know a nurse with FPS syndrome and are reluctant to give the disease a name…. well, let us help you out.  If you would like to publish this groundbreaking work in your own journal you may contact us through this blog .  Enjoy, laugh at the self-recognition, learn how to say ‘no’ and help your peers to do the same. Healthy nurses make for healthier patients.

P.S. Does this count as publication for our PhD degrees? What? NO? Oh Drat!!!!

APA Citation: Hart, C. & Schmitt, T. (2011) Full Plate Syndrome: A chronic nursing malady.

Full plate syndrome (FPS) is one of the most common adult disorders, particularly prevalent among nurses. It is a chronic debilitating disorder with side effects that include inattention, impulsivity, over-achievement, and inappropriate humor. FPS affects women more commonly with a ratio of women to men of 3:1. Onset typically occurs in the early 20’s; however, the average age of diagnosis is actually between 31 and 42 years. FPS affects many aspects of a nurse’s life, including parent–child relationships, academic performance, social skills, and self-esteem. It was previously thought that nurses outgrow FPS, but it is now known that up to 60% of people with FPS continue to have significant symptoms as older adults and well into their nursing home years as they become overly involved in church, Rotary, nursing organizations, volunteering, bunko, or other gaming groups.

Adults with this disorder are at an increased risk for academic achievement, work overload, and increased involvement with children’s sports groups or nursing organizations. They also have a significantly greater risk pathological multi-tasking. Currently, as an unrecognized disorder, FPS is not treated. However, nurse mangers, supervisors, and peers resist accurate diagnosis of co-workers with FPS as workloads may then significantly shift. The aim of this article is to provide an overview of the diagnostic criteria, clinical assessment, and treatment of nurses with FPS.

Etiology

Presently there is no one identified etiology of FPS. Anecdotal evidence suggests there are multiple contributing factors. Multiple environmental and genetic factors increase the chances that an individual will develop FPS. For example, if one’s parent was overly achieving, the child may also exhibit FPS symptoms. The frontal lobe and its’ function in attention as well as the hippocampus and memory are thought to be possible regulators for FPS and may in fact be functioning improperly in nurses with FPS. It is also hypothesized that nurses with FPS have an imbalance in caffeine and chocolate levels which exacerbate symptoms.

Other research has found that there is a two-fold increased risk of FPS in nurses who were exposed to FPS through association with mentors or coworkers with the same syndrome, thus supporting the theory of environmental exposure as key in the development of FPS. An interesting phenomenon has been noted by the authors, whereby individuals with FPS naturally align with others who are also affected by the syndrome.

Social consequences of FPS

Nurses with high levels of memory loss, impulsivity, and hyper-distractibility experience more FPS and are more likely to become associated with multiple organizations and/or causes. Also noted is a particular sub-phenomenon associated with FPS known as Over-Achievement, Need-to-Excel, and Inability to Say No, or OANEISN. OANEISN can occur when nurses with FPS have symptoms of hyperactivity, verbal outbursts, over-excitability over new ideas, and the inability to engage motor control with cognitive functioning to verbalize the word “no”. It is not uncommon for nurses with FPS to be bombarded with requests to edit manuscripts, review work, and volunteer to organize a group nursing activity, or serve on a board. OANEISN not only affects levels of FPS, but additionally carries social stigma as family and peers may find this behavior to be offensive, impolite, apathetic, and selfish. OANEISN and FPS contribute equally to the marginalization of affected nurses.

Diagnostic Criteria

The American Psychological Association does not currently recognize FPS, resulting in marginalization of nurses with FPS. FMLA, which could be critical in treating acute exacerbations of FPS is denied to these nurses. It is suggested that diagnostic criteria include, but are not limited to one or more of the following: working more than one job, belonging to more than two nursing organizations, more letters than are in the alphabet following the nurses name, and inability to attend a meeting without committing to more work.

Suggested Treatment Guidelines for FPS

The only known treatment for FPS is intense behavioral and cognitive interventions designed to make sustainable life changes. Time spent on warm sandy beaches with no mobile phone coupled with speech therapy designed to teach the FPS sufferer the oral-motor skills needed to formulate the word “no” are thought to be helpful. Likewise, reading non-health care related fiction books, massage therapy, naps, and sabbaticals may also be helpful. For nurses with strong social support systems and actively involved co-workers, no treatment may be necessary other than heightened awareness.

Conclusion

FPS is a potentially devastating syndrome with far-reaching consequences. Society may benefit from the hyperactivity and high workload of these nurses, but this is done at the consequence of the individual’s sanity. High burn-out levels of nurses with FPS are consistently noted. To prevent the loss of these very valuable individuals, other nurses are called to volunteer for service in organizations and social endeavors, transferring the burden from the hands of a few to the shoulders of many.