Answer:Ivy Carter had previously been admitted to a regional neurosurgical unit following a spontaneous intracerebral haemorrhage. During her hospital stay she presented with disturbances in consciousness, acute confusion, florid hallucinations and delusions.
“After a protracted period of rehabilitation, Ms Carter recovered and was able to give a retrospective account of her hospital experiences. She remembered vividly a television being put in front of her, but she thought the events on TV were actually happening and that she was part of it. This was particularly frightening when violence or noise were depicted. Because staff had switched the TV on, she thought they were also part of the cause of the violence and reported feeling paranoid about the nurses’ motivations. I reflected on this seemingly benign act and considered how good intentions can be misinterpreted by patients who are not in ‘our reality’.Unless we listen to these accounts, we can never appreciate how our actions might be perceived and whether harm and distress is unknowingly caused. Although her perception of reality was clearly distorted by her cerebral injury, Ms Carter’s story is a reminder that unless we take time to understand patients’ lived experiences, and perhaps attempt to view our actions and the environment through a ‘confusion lens’, we will never deliver the high-quality care patients have a right to expect.
“The hospital environment for the orientated patient may, at times, be confusing and hectic but for the confused patient it must be a profoundly disturbing and distressing place to be. As a result of my work with Ms Carter, I have started to research patients’ memories of acute confusion as part of my PhD study.”
