Delusional Patients and "therapuetic communication"

[RN*06]

OK - I have about had it with all the different responses I have found for delusional patients! So, do we communicate therapuetically and "explore" their delusions and give them a chance to express them, or do we "discourage" letting them talk about the delusions further by distracting or just stating the truth. Im confused

[DolphinRN84, MSN, RN, APRN, NP]

Hi there. :) From what i remember, with a delusional patient, you have to pretty much "get them back into reality." For example...if i had a patient that told me that he saw some bunny that told him he had to jump off a cliff or something..( silly example), I think you would tell them that, there is no bunny. The bunny isn't real. I got confused too with this when i was studying, because you have to becareful not to be judgmental, and you also don't want to reinforce the delusions that the patient is having. Hope this helps somewhat....:)

Also!! I just wanted to add that you could also tell the patient that, its not real, but it must be frightening for you...something like that. :)

[willdgate]

Do not explore the delusion, get to talk about something reality based, like the weather or what's on tv, now. Recognize the delusion, but don't dissect the delusion.

[RNLisa]

Pt: "Get those ants off of me!!" Reality: No ants. Nurse: "I don't see any ants, but you seemed very frightened"

this was an example NCLEX question scenario with the nurse's response I typed was the answer.

[kellyo, LPN]

I learned from one of my practice questions (not sure if it was Kaplan or not) if someone is actively "hearing voices" you must ask what they are saying to assess if they are being told to hurt themselves or anyone else. Remember, safety first!