A+O x ...

The days where I could go into a patient's room and have a normal conversation feel like a distant memory. Seems like everyone around here lately is disoriented, or has dementia, or my personal favorite: psychosis. In fact, of my 4 patients this week, 3 have "altered mental status" or more succinctly, a case of the crazies. I have spent this week explaining to my 80+ patient that he doesn't have to crawl out of bed to go to a wedding. There are no weddings on Monday. The rest of our time together I have to convince him that I'm not torturing him, he is not a prisoner, and that there really is someone "running this damn Mickey Mouse show". My next gem is an alcoholic with a history of seizures who we're doing every 4 hour CIWA checks on. We're usually good until I get to the questions about hallucinations, at which point he tells me that he sees other people's faces on my body. Familiar faces, like the ones from tv. So really, he says, I don't know what you look like. Seemed logical to me at this point to describe my face. He got mad. Apparently "I don't understand". The latest is a paranoid schizophrenic who lives over at the mental health complex. I got him as a transfer out of the medical ICU. The first thing he said to me was "I'm going to need 5 mg of Haldol PO. I'm feeling paranoid. There was a doctor upstairs who's stethoscope touched my foot. She was very pretty. It felt very sexual". Oh good. There is a reason that I'm not a mental health nurse, and this is because I don't have a whole lot of patience for crazy. And because I find it much easier to go along with people's delusions than to reorient them. So yeah, I'm telling the sundowning elderly lady that her plane doesn't leave until tomorrow, so she can spend the night here. What of it? Somedays, that's the only way I can keep MYSELF sane :)