it is as it
should be. No arguing would convince him, for, to his mind, the nurse is
either a complete dupe or an agent of the people whom he knows are
plotting his death. And urging him only strengthens his conviction.

The writer recalls one such case of a patient who had to be tube fed
through many months, though a tray was set before her three times a
day--and as regularly refused. Then one day she was seen slipping food
from off another patient's tray and eating it greedily, not knowing she
was observed. When questioned, though she had never before given a
reason for refusing food served to her, she said that "they" had nothing
against Mrs. B., so wouldn't try to poison her. Her reasoning was
excellent when one accepted her premises. She had bitter enemies. They
were not enemies of Mrs. B. and would not harm Mrs. B. Therefore she
dare not touch her own food, but could eat Mrs. B.'s if no one knew.

These deluded patients live in a world we often do not sense, a world
whose reality we do not appreciate. The nurse, after much experience,
finds that there is a key to every resistance, to every lack of
co-operation, to abnormal attitudes and actions. She realizes that a
powerful emotion of desire or fear, of love or hate, of ambition or
self-depreciation, of hope or despair, of faith or distrust, unchecked
by reason or judgment through the years, has provided a soil upon which
emotional thinking alone can grow. The patient is a mere puppet of the
suggestions of emotions which may not be at all pertinent to the facts.

NURSING THE DELUDED PATIENT

The nurse soon realizes the uselessness of attempting to argue a patient
out of his delusions, of trying to convince him that the things he sees
and hears and perhaps tastes and feels, are but hallucinations. Her very
insistence only fastens his attention more firmly upon the false
conclusion or makes him more convinced that his mind is giving him a
true report from the senses of sight and hearing and taste and feeling.
But often a quiet disregard of the delusions while the nurse goes on her
way and holds her patient to his routine, consistently and confidently,
as she would in case they were not true, will eventually cause him to
question their reality just because no calamity results. The nurse acts
as if these delusions and hallucinations were non-existent in reality,
and when the occasion arises, through the patient's questioning, she
urges him to exert his will to a