But for argument's sake, let's assume it's Delirium . What people *mean* when they use the term "pleasantly confused" is generally hypoactive delirium (so "no trouble" even though this condition may signify serious medical diagnoses & a distressed person)
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Replying to @mancunianmedic @grepmeded and
If Dementia, then the "PC" term probably means that if they have Behavioural and Psychological Symptoms they aren't manifesting with what looks like verbal/physical "aggression", restlesslness, vocalising, "wandering" etc and so are "no trouble" (though may be terrified)
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Replying to @mancunianmedic @grepmeded and
If it's another cause (let's say a closed head injury with a worsening intracranial bleed) then "pleasantly confused" might mean their conscious level has become so depressed that they are no longer exhibiting psychomotor agitation etc
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Replying to @mancunianmedic @grepmeded and
so basically, a bit like "acopia" - it's best avoided completely as its imprecise, misleading and the confusion may be far from pleasant for the patient. A term like "hypoactive delirium" is a better bet
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Replying to @mancunianmedic @grepmeded and
Picking out hypoactive delerium for experienced clinicians in optimal conditions is one thing but for stretched staff in chaotic ED with more dramatically disturbed people... we need a lot more training (&staff)
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Replying to @Jdbartlett0703 @grepmeded and
i didnt claim it was easy or straightforward.Merely that we shouldnt use the term "pleasantly confused" - when someone asked about this. Same for "acopia" "social admission" "failed OT assessment" "no rehab potential" "off legs ? cause" "mechanical fall" and other unhelpful lingo
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Replying to @mancunianmedic @Jdbartlett0703 and
the original question was do doctors use this phrase- yes, and frequently. And no harm is done. The reality is during rapid handoffs and note writing a variety of suboptimal terms are used without intent to offend. We’re clinicians not scribes.
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Replying to @grepmeded @mancunianmedic and
I would also argue “hypoactive delirium” is much more likely to confuse a junior nursing student or medical student whereas “pleasantly confused” with some choice additional verbiage a monkey can understand.
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Replying to @grepmeded @Jdbartlett0703 and
someone studying for a degree in nursing or medicine shouldn't be unsettled by precise clinical terminology. would you say "let's not say Grade 4 Sacral Pressure Sore" in case it'was a bit much. Nope we are never going to agree on this. I give uo
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Replying to @mancunianmedic @grepmeded and
If hypoactive delerium is more useful than the colloquial language we have to convince staff of that. The current linguistic mess around sepsis is my bugbear; the technical language is contested by experts. If it matters we need to make it matter.
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The Doc who charts “hypoactive delirium” or sepsis3.0 is no better than the one who writes “pleasantly confused” if you ignore the patient in front of you. Charting is not patient care. I actively tell my trainees to write worse notes and spend time with patients or self-care.
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