I feel like I have a moderate level of understanding with the concept of delirium. It was covered in our last semester’s mental health nursing course and we had a presentation about it during clinical when I was at NERHP last fall. Delirium is a sudden onset of confusion that is often accompanied by hallucinations. Patients who experience an episode of delirium often have worse outcomes, like a 40% one year mortality rate. To prevent delirium we are taught to re-orient the patient frequently, get them used to their environment, and to keep them active and involved in their care plan.
Over the summer I was an ED tech at UMass Memorial and did a one-to-one with a delirious patient. The patient kept trying to get out of bed and made several remarks that made it seem like he thought he was in his kitchen. The patient would see someone walking by his door or hear someone out in the hall and think they were his son or daughter. The patient also kept trying to remove his johnny.
I would like to get a better sense of nursing interventions that are put in place to help patients avoid delirium and be able to understand what older adults experience during a stay in the hospital. We’ve done a lot of classroom education about delirium and we experience hospital life as nurses and CNA’s but I think this would be a good opportunity to build empathy with our patients. It can be distracting when we’re on clinical and we’re trying to focus on learning our charts and giving meds, it will be nice to go in with the sole purpose and not juggling a bunch of tasks. I’m a little worried because I feel like our orientation didn’t give me a good idea of what we’re going to be doing with patients, it felt more like an overview to the HELP program as a concept. But I feel prepared to go into patient rooms and interact with someone I hadn’t met before in a medical context, so overall I’d say I’m optimistic.
I know there are other hospital support systems in place, the first one I go to is chaplain support. Being in the hospital can invoke feelings of helplessness, fear, and remind people of their own mortality. Especially after a health scare, patients have questions about life and their place in the universe, it can be nice to get someone else’s perspective, especially if they share the same faith, although I believe there are non-denominational chaplains or spiritual advisors. Outside of the hospital, programs like visiting angels and meals on wheels can help older adults to check in on them and ensure access to food.
