A patient that is admitted and suffers from a form of
mental illness may have an extra hard time adjusting to a hospital stay. When a patient is delusional they may have
irrational thoughts, and they may have reactions based on those irrational
thoughts. In order to properly handle
and treat a patient in this condition, it's important to understand some about
their thought process and condition.
What is a Delusional Disorder?
This is a form of mental illness, although it can be
brought on by a number of factors.
Certain drugs can cause delusions, while in some cases the person
suffers from the condition with no known cause. Some may refer to this as paranoid thinking, however delusions are a
different form of psychosis, similar but not the same. A patient that is delusional may think that a
multitude of thoughts, which can include paranoia thoughts such as someone is
trying to harm them. They may also see things
that are not present, or hear things that are not omitting sounds. Essentially the patient may believe in
something that never existed, or something that they remember from another time
or place. Delusional patients may feel
that someone is trying to poison them, harm them, deceive them, or conspire
against them, and it could be people that are not even in existence.
Working with a Delusional Patient
Keep in mind, that a patient that is delusional may not
visualize you as a nurse. You could
appear in some other entity, which could be dangerous. For safety measures, if the patient has
physical stamina its best to have someone with you when you are working with
the patient. They may not intend to harm
you at all, however they may see something besides you, due to the psychosis,
which in their eyes may pose an extreme threat to them. Any medications you are planning to
administer may appear as poison to the patient, again, a second person in the
room may prevent an accident. Always ask
the patient if its ok prior to doing anything, even tucking in a sheet or
adding a blanket. Talking in a calm
voice, and avoiding sudden movements near the patient is likely to ease
tensions. If the delusional thoughts
originated from drugs, as the patient withdraws they may improve, however it
often increases in severity prior to getting better.
Forms of Delusional Disorder
There are various types of this disorder, and it’s
important to know which type you are dealing with in order to provide safety
for the patient. Erotomanic is a form of
delusional thinking that provokes the person to believe someone, usually famous,
is in love with them. This has caused
many of the stalking’s of famous actors and actresses over the years. The person believes that the victim wants to
be followed and watched, so they are very confused when suddenly they are
arrested. This generally leads to psychiatric
treatment rather in imprisonment. If
you have ever met a person that is overboard about what they can do, or who
they are, this is a form of Grandiose Delusion. They may appear to have an extremely high self-confidence, however the
things they believe they know, and can do are often simply in their minds. Even extreme jealousy can get to the point of
being delusional. The more jealous a
person is, the more it may build in their minds, and the imagination begins to
take over.
It’s easy to see how a delusional patient could pose
danger under the right circumstances. Delusional thoughts can often be treated and kept under control with medications
and therapy, however until a patient is deemed under control, extreme caution
should be exercised when working with them.
Remember, the patient has no control over irrational thoughts, visions,
or sounds, so don’t try to tell them they don’t exist, but instead divert the
conversation if possible. Safety first:
Visit the patient in pairs for everyone’s safety.
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