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Discussion

Do you know where you are?

To assess orientation in the PACU, once my patients are awake enough to have a prayer of knowing the answers, I ask all of them (except young pedi) some version of the "pop quiz":

1. Can you tell me where you are?

2. Can you tell me what day of the week it is?

3. Do you know what surgery you had today (or, if they are more awake, name of surgeon)?

4. Something else like who is the president of the United States, what is your birthday, who is in the Superbowl, etc.

When I was on orientation, we had a patient who had undergone a craniotomy, so after cranial nerve assessment, assessing orientation was my next priority. The patient was an adorable little old lady who, unbeknownst to us, was very feisty. I leaned over so she could hear me and said, "I'm going to ask you a few questions that I ask all of my patients. Do you know where you are?" She nodded. "Can you tell me where you are?" I asked. She opened her eyes a tiny slit and declared (in a voice that clearly indicated that I had lost my mind), "I'm RIGHT HERE." Guess she told me...

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    My mom had several strokes. After one, the PT was trying to walk with my mom and said "Katherine, you're leaning to the left.". Mom's response: "that's my politics."

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    I work on a neuro/stroke floor. I learned really quickly that asking who is the president can lead to some very inappropriate answers. I shy away from that one now.

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    Hahaha! That is funny!

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    Ed4nurses has cd's I listen to. During his assessment, or first time meeting his patients for his shift, he introduces himself and tells them his name and two more things about himself (like his favorite color is blue and he loves baseball). Then he asks patients to repeat his name, blue and baseball everytime he comes into the room. Pretty soon, the patient sees it as a game and everytime he goes into the room the patient says, "Hi David, blue, baseball". No need to ask questions because the patient is alert and orientated. I thought it was a good idea and thought I would share.

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    Ed4nurses has cd's I listen to. During his assessment or first time meeting his patients for his shift, he introduces himself and tells them his name and two more things about himself (like his favorite color is blue and he loves baseball). Then he asks patients to repeat his name, blue and baseball everytime he comes into the room. Pretty soon, the patient sees it as a game and everytime he goes into the room the patient says, "Hi David, blue, baseball". No need to ask questions because the patient is alert and orientated. I thought it was a good idea and thought I would share.[/quote']

    I love this! Great idea.

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    I work on a neuro/stroke floor. I learned really quickly that asking who is the president can lead to some very inappropriate answers. I shy away from that one now.

    Oh man, I get some absolutely stunning answers to this in the ED. :banghead:

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    I work night shift and half the time I can't appropriately answer "What day is it/what's the date?"

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    I work night shift and half the time I can't appropriately answer "What day is it/what's the date?"

    If my phone weren't in my pocket I would never put the correct date on the board in patient rooms. Never.

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    When the patient can tell me both the day AND the date, I'm always impressed--I have to look at my watch!

    Also, I had a similar experience to Msjellybean when it was election time. I'd ask who the president was or who the candidates were, and let's just say that it was obvious that no one had a neutral opinion on the subject...

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    I shy away from asking the specific date also (hard for me to keep straight working nights as well!) & instead will ask for the month, season, or what holiday was just celebrated.

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    I had a patient once who would give random answers because she thought I'd leave her alone as long as she gave an answer. :laugh:

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