Sometimes, in clinical notes, you will
see O x 4 or O x 3. This means the
patient is oriented to self, location, time and situation. (Some places just
use three and exclude situation.)
What I have learned is in assessing
orientation, an odd answer doesn’t always correlate with disorientation.
Example One:
There was a time when I had pet bunnies
that were litter box trained. I worked on a very small surgical rehab unit and
occasionally I would bring them in. Most patients liked giving them a pat and
telling me about their pets.
We had a gentleman who did have some
confusion and issues with short term memory. (That is fairly common in older
people who have had a recent surgery. Hopefully it improves, but it doesn’t
always.)
One day we were having our team meeting
and a nurse said she was concerned about this patient. “I think he is getting more confused. He keeps telling me about a lady who brings
him rabbits.”
Example Two:
I had a friend who worked at a large
dementia facility. When she was new, she
interviewed a patient who asked her if she had seen the kangaroo. Well
obviously not and she documented that the patient was disorientated.
Then she interviewed another patient who
asks about the kangaroo.
Yep, turns out this particular facility
does have a kangaroo, which is awesome but perhaps not the best choice in a
dementia facility.
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