Registered Mental Health Nursing (RMN)

MANAGING A PATIENT WITH INAPPROPRIATE THOUGHT CONTENT (DELUSION)

This is the process of assisting a psychiatric patient who cannot tell what is real from what is imagined to gain an awareness of the symptoms and be in touch with reality. It involves the use of a sequence of psychological steps that the nurse can use to aid a patient to organize and interpret reality. This patient usually has unshakeable beliefs in something untrue despite the availability of clear evidence to the contrary.

Purpose

Help increase awareness of the symptoms to interpret reality
Prevent patient’s condition from worsening
Promote recovery

Equipment

Table
Chair
Pen and paper
Patient’s folder (Electronic/Manual)
Serene environment

Procedure steps

Establish rapport (refer procedure) and explain procedure
Interview patient to determine whether delusion is present
Respect patient’s views, maintain control and distance during interview
Encourage expression of feelings and thoughts
Identify precipitating factors
Show acceptance, listen and avoid arguing with patient
Give honest perceptions of reality in feedback
Observe for verbal and non-verbal cues
Inform patient about the support system available
Teach patient therapeutic values of medicines and daily routines that promote compliance
Express appreciation and direct patient to the next activity
Document observations and findings in nurses’ notes/patient’s folder

References and further reading

Educational resource only. Follow current Nursing and Midwifery Council guidance, local institutional protocols, scope of practice, and clinical supervision.

Open Component Task app