I’ve seen post op delirium in so many of my patients – especially hip surgeries, and of those, especially after a fracture. It’s distressing to me, as a nurse, but even more distressing to my patients’ families. We tell them it’s temporary. We tell them it’s common. We tell them we know exactly what we’re doing. But the truth is, delirium is scary.
The mortality rate in patients with delirium is equal to the mortality rate of myocardial infarction or sepsis. While we respond to delirium as a temporary and reversible condition, the truth is that more often than not, the individual is discharged from the hospital with cognitive and behavioral deficits when compared to their baseline, and often show memory impairment for many months afterwards. It also leads to longer hospital stays, increased institutionalization after discharge, and much higher mortality rates in the two years following discharge.
Everything I read while pulling together research treated post operative delirium (or other incidents of delirium) as a medical emergency. But on my floor, I’ve never seen anyone respond with any urgency when a patient develops delirium. We rarely label it as delirium – we just say “he’s confused,” or “she’s sundowning.” When someone is given the label delirium it is often treated as any other unsurprising development. “Oh, she seems delirious,” is heard with the same amount of surprise as “oh, he’s due to void.” Simple problem, simple fix. But there’s nothing simple about delirium.
To help raise some awareness among those of us (myself included) who don’t feel 100% comfortable with identifying and treating delirium, I made a little reference sheet for myself. And since I like to share, I’m making it available for download. Be a gem and don’t plagiarize, k? Click here to download