Orientation to reality?

[evans_c1]

We tend to get the good 'ole confused and combative patient from time to time. I find myself at a loss for words when communicating with these pts. I just try to tell myself that "they cannot think rationally when I am trying to keep them in the bed and not falling" but the whole orientation to reality crap just does not cut it sometimes. What are your thoughts on the concept. We had an elderly man who kept trying to jerk out his foley and picc line so we had wrist restraints on him and he kept askinng us to cut his hands off...haha. It is a real problem for me to calm down these people and i was wondering how you dal with them 1:1?

[meownsmile, BSN, RN]

Sometimes there is no dealing with them. They become more confused and agitated the more they are "reoriented". It sometimes comes down to moving them as close to the desk as possible so you can keep an extended eye on them so you can intervene if things get hairy. Tv isnt the answer as it sometimes it stimulates them to much and they continue to be iritated. Quiet tends to calm, although they dont stop wanting a knife to cut those braclets off, they may drift off to sleep for a while.