Hospital Clocks: Taking Delirium To The Next Level

I've taught you about reorientation techniques for traumatic brain injury patients.  I've even taught you about the 5Ps of hourly rounding for nurses.  I now present to you the next generation tool in nursing plans of care:  The three armed hospital clock.

I took this picture of this giant three armed hospital clock stuck to the wall of my patient's room.  I was kind of taken back by the monstrosity of it all.  This thing is huge.  

Happy:  What the heck is that thing?

Nurse:  It's something we started a few weeks ago.

Happy:  It's a three armed clock.

Nurse:  I know.

Happy:  You're going to make my confused patients really confused.

Nurse:  I know

Happy:  I don't get it.  What's the point of hanging a pediatric looking three armed clock in the rooms of elderly patients with dementia?  You're just going to agitate them and think they are looking a three armed clocks.

Nurse:  I know.

Happy:  What do all the arms mean?

Nurse:  The move arm is to remind us and the patient that it's time to move.  The pain arm is to let the patient know when their next pain pill is due.  And the toilet arm is to remind us to ask the patient if they need to use the restroom to prevent incontinence.

Happy:  You do this on all your patients?

Nurse:  Yes.  At least when I remember to move the arms.

So let me get this straight.  Between all the ridiculous computerized documentation requirements, hourly rounds, medication administration, answering call lights, communicating with other doctors, nurses, lab people, and taking lunch break,  we are now asking our nurses to remember to change the arrows on a three armed pediatric clock that will cause demented patients to question everything about their existence?

Rest in peace nurses.  Rest in peace.    It's time to apply for nurse practitioner school.  You can use  your hundreds of hours  of experience clocked in to independently  take care of patients who show up in clinic with undefined weakness and a chief complaint of not feeling well. Make sure you bring a clock with lots of arms.  As a reminder, you know, of the differential diagnosis.