Postoperative confusion.

Confusion is a terrible feeling, a feeling of being lost in the most basic sense. The markers, maps, cues, and senses used to orient oneself to the immediate environment are not recognizable. This applies to what one sees, hears, and feels. The person searches for something that makes sense, that he or she can anchor thoughts or actions to. Sitting up, getting up, and walking are anchoring responses. Using hands to touch one's own body, fingering objects, and "calling out" reflect a searching for something that is meaningful to the individual. Patients in various clinical settings who have experienced confusion all report common feelings: anxiety, fear of dying or being hurt, pain, falling, floating, suffocating, feelings of being crazy, being chained, or being lost. The severely confused seem only able to share the experience through their behavior; but it is clear that acute confusion is a physiologic and psychological assault on the body and mind, often worsened by nursing and medical interventions. Acute confusion continues to be a misdiagnosed and undertreated problem. Continued clinical inquiry and research into acute confusion and the use of such knowledge in the practice setting can reverse this trend.