Demystifying Mentation

[KaleidoscopeLv]

How often do you receive report on a patient that is supposedly AAOX3 and moments later find that the patient is unaware of surroundings/time.I always give report on their CURRENT mental status . Not what their neuro status was a week ago.

[CountryMomma, ASN, RN]

This didn't demystify anything. I've had pt's who fluctuate in their A&O status from shift to shift. Good luck.

[Dogen]

Ideally everything in your report should be current, rather than a week old. Not only their current mental status, but whether it has changed. If no one has mentioned it to their provider that should also happen.

Delirium is always the first thing I think of when a patient's mental status changes, since it's a big risk factor for people in hospitals (especially older adults and post-op), but of course there could also be underlying physical changes, too.

[xoemmylouox, ASN, RN]

Mental status changes can occur quickly and can be a sign of a serious issue. This is why an actual assessment is required and not just copying the information from the shift before. OP was there a purpose to this post or just a mini rant?

[KatieMI, BSN, MSN, RN]

Some of patients "float" in and out of reality with waves frequency of literally minutes.

I am more concerned about that ubiquitous "delirium screen" being done always the same way, questions asked in the same order. I saw quite a few people who did not remember why they were in hospital and what year they were living into, but they nicely "followed commands" (squeezed my finger, as well as edge of blanket, spoon or anything else finding way into their palms) and consistently did at least half of that "delirium screen" correctly because they somehow memorized the questions.