ABSTRACT
In the business of attempting to resolve acute physiological crises, psychological care can be consigned to afterthoughts. Delirium increases morbidity and mortality, causing psychological stress to patients and families, reducing motivation and prolonging recovery. Delirium may be: hyperactive, hypoactive and mixed. Delirium is difficult to manage but can be reduced by: patient orientation, communication, mobilisation, analgesia, and rationalising drugs. All intensive care unit (ICU) patients should be assessed for delirium. Even if eyes are open, ICU patients often have distorted vision from: drugs, absence of glasses, and restricted visual field from positioning of head or equipment such as ventilator circuits. Understanding patients' perceptions and interpretations is not always possible but can make sense of hallucinations and bizarre actions. Nurses should actively reduce unnecessary noise, especially overnight. Circadian rhythm, the body's daily rhythm, is a "clock" regulated by the suprachiasmatic nuclei, in the hypothalamus. Sleep is essential to physical and psychological health; sleep deprivation increases mortality.
