hallucinating patients

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Hi. I work on the intermediate side of the neuro intensive care floor. (will be taking the next icu course asap!) The other night i had a patient who basically woke up thinking that she was in the movie she "saw on tv". She became very agitated and verbally abusive saying that the nurses were trying to kill her. She even called 911 from her room phone! It seemed that every time I tried to reorient her, it made her worse and even more paranoid. from about 2:30 am until the 6:15 it was basic h*ll, when finally 6:15 she called me in there and was crying and upset and apologetic for last night. She finally came back to reality i guess you could say. My question is does anyone have any tips for these type of patients or do i just do what i did the other night and hide in the back of the nurses station? lol Any advice would be great. That was my worst night so far having graduated back in December.:sofahider

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Specializes in Neuro Critical Care.

Sounds like you did everything right. Keeping the patient safe is the goal. It's amazing that she was able to remember everything that happened. I had a patient over the weekend who was hallucinating (although not like your patient) and he remembered everything. He was completely intact neurologically the whole time, just saw flowers and butterflies on the ceiling. He was pretty cool about it.

Sometimes it is helpful to have security come see the patient, especially if they think you are trying to harm them. They will feel safer knowing the "police" are there if she needs them.

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Specializes in Medical.

I know this isn't quite the same, but I quite often look after aptients who wake from vivid dreams and can't separate them from reality.

Last week I went to check on an intermittantly confused woman who was calling out. When I asked what was wrong she said "There's something inside me."

I told her she had a catheter and an IV, but that was all.

"No. There's a duck inside me."

A duck? What kind of duck - a toilet duck, a rubber du-

"A real duck, in my private parts."

I told her I thought she'd had a really vivid dream, and that it was okay, there was no duck in her private parts, but I had to do an external visualisation before she believed me, and even then she wasn't wholly convinced...

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when my pts are hallucinating, i never try to reorient them as it does just cause more agitation and paranoia. i try to find out what will make them feel better or safe. as for the duck in the lady's genetalia, dang, that would be a tough one. perhaps stating "we have a no ducks allowed policy in this hospital and there's no way a duck could get past the security guards"....oy.

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Specializes in Utilization Management.
"we have a no ducks allowed policy in this hospital and there's no way a duck could get past the security guards"....

:rotfl:

Of course, if someone complained loudly enough, we might be able to make an exception.....

:rotfl:

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Specializes in Medical.
:rotfl:

Of course, if someone complained loudly enough, we might be able to make an exception.....

:rotfl:

"I want my duck and I want it NOW!!!" :chuckle :chuckle :chuckle

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That gives a whole new meaning to the game "Duck, Duck, Goose!" :chuckle

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"I want my duck and I want it NOW!!!" :chuckle :chuckle :chuckle

"sorry ma'am but your duck is currently between a woman's legs. we appreciate your patience" :chuckle

leslie

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Specializes in Medical.

"I'm sorry, all our ducks are currently in service. Your request will be placed in a queue and a duck will be with you as soon as possible. Your request is important to us. Thank you for waiting."

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"I'm sorry, all our ducks are currently in service. Your request will be placed in a queue and a duck will be with you as soon as possible. Your request is important to us. Thank you for waiting."

i think it best for me to stop w/the duck jokes before i get kicked off this board. :D

yet i do maintain to go w/your pt's hallucinations.

one time i was caring for a lady that had ca w/mets to her brain.

i heard her frantically crying out.

i ran to her room and she was crying her cat got away and was wildly pointing her finger in the hallway, "there she is, there she is!"

i immediately said she went in THAT room where i knew this particular room had a collection of beanie babies in it...i took the kitty beanie baby and gave it to my pt.

you could see the relief in her face as she gently placed it next to her, scolded the kitty for running away and couldn't thank me enough. phew.

doesn't always work out that well.

anyway, she peacefully passed that noc, holding her kitty.

i don't care what they teach you in school. there's a certain population of pts that you just cannot reorient to reality.

leslie

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Specializes in Medical.
i don't care what they teach you in school. there's a certain population of pts that you just cannot reorient to reality.

I agree - with some it just makes them more distressed and agitated.

Nice story, BTW :)

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thanks.. it was definately my worst night so far.. and the longest!

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