Monday, April 7, 2008

Intensive care units - not relaxing places

Post number 250!

This story was interesting for me: ICUs begin to adopt patient safety checklists . I worked in an ICU for a while near the beginning of my nursing career and I was a patient in an ICU a few years ago, for a couple of days. I have to say, being a patient there is a unique experience - a time when unique does not mean something good.

Intensive care units are a vital part of a healthcare system, particularly now as patients are even sicker than they were when I worked in one. The specialized one-on-one care can't be replaced by anything else. But being a patient in an ICU can be traumatic for many reasons.

There are the obvious reasons such as fear and uncertainty, but there are also the insidious problems. I remember that we would have patients who became quite aggressive and upset while in our unit and their family members would be mortified at the behaviour, saying "he/she never acts like that," or "he's the sweetest man you could know."

We had an explanation for some of that behaviour and it was often the lack of true rest. It's hard enough to get a good night's sleep in any part of the hospital. The saying is "don't go to the hospital if you need to rest." This is particularly true for patients in a specialized unit like an ICU. As much as staff try to make it "night like" at night, it's not possible to turn off the lights completely or eliminate the noise.

How many people have experienced just dozing off, only to be woken up because a nurse has to do something? While we try hard to avoid unnecessary tasks while our patients are sleeping, it's not always possible in an ICU because of why the patient is there. Add to all this the noise from adjoining rooms/beds, the whoosh of respirators, the beeps of machines, and so on - this all adds to making it very difficult to fall into a restful and restorative sleep.

And now, many patients and families feel the added stress of fear of infection. With the so-called super bugs taking up residence just about anywhere, patients and their loved ones are frightened; they're scared of getting sicker just because they were in the hospital. Worrying about if their doctors or nurses have washed their hands is something that they shouldn't have to think about. So, will checklists like the one mentioned in the article help? I don't know. I like to think that we're all adults and we know that we're supposed to wash our hands before moving to another patient. But if a checklist helps for those who don't, I guess it can't hurt.

Today at Help My Hurt:
Company’s calling - living with ulcerative colitis.

News for Today:
Health Canada warns against bogus STD medications
British pharmacists allowed to prescribe drugs, provide medical care
ICUs begin to adopt patient safety checklists
Early neglect predicts aggressive behavior in children
Occupational therapists use Wii for Parkinson's study
Parents follow pediatrician advice on administering MMR vaccinations


Anonymous said...

You are expressing ICUfacts that are suprisingly everywhere, as I assume that you are referring to Canadian ICU, and I am referring to the US ICU I am practicing in. Yes, there should be more emphasis to restorative rest and deacreasing external stimuli to help patients heal.
Personnaly, I try to consolidate my care when the patient is awake, or divide it according to how energetic the patient is. Not always easy... to be a patient.
I am a firm believer that if we can explain the "plan" of the night/day, it helps the patient to prepare themself... to get disturbed again... according to their level of anxiety.
Hope to hear more about the + and - or your ICU experience so we can learn from you! Hope you are well now too!
As for the check list, I am interested, where could we see one?
I read you often, keep it up!
Marie Conny ICU RN in US soon in Quebec

Leo Levy said...
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