Acute confusion or delirium is an acute brain syndrome, which may be transient and reversible. Key features are a clouding of consciousness and difficulty registering or making sense of new information. Nursing management includes managing confused thoughts by keeping communication clear, brief, and to the point, encouraging correct orientation, responding to distress, listening to the patient’s concerns, and ensuring the safety of the patient. Psychoses are disorders of thought, feeling, and perception that lead to difficulties relating to self, other people, and the world at large. They are rarely encountered in the cancer care setting, but they are distressing and difficult to manage when they are. It is important to engage the patient and maintain a safe environment. Incidents of violence and aggression are relatively uncommon, but distressing. It is important to identify the causes, e.g. frustration, fear, or confusion, and to respond to the person, but set limits and ensure safety. Alcohol misuse is associated with many health problems. Nurses should recognize the effects of hazardous drinking and alcohol dependence, and advise the patient on sources of support.