Understanding post operative psychosis and sleep deprivation: a case approach

The care of a critically ill, intensive care unit patient dangerously out of touch with reality, is a challenge requiring exceptional problem solving skills. This article will discuss the nursing management of a distressing, unusual case of post-operative psychosis. Specifically, this case involved a patient who suddenly became psychotic on his first post-operative day after having an atrial septal defect repair. The patient's self-destructive actions and the innovative strategies used by nursing staff to effectively intervene are described. Discussion of the complex interrelationship of factors that contributed to this patient's erratic behaviour is highlighted. Questions about the effects of sleep deprivation are raised.