The New Dawn: Non-Technical or Human side of Critical Care Units.
During this pandemic of COVID-19 the media has emphasised and exposed to the world -the most stunning advances in medicine – Critical Care medicine ( ICU’s). Now, to the surprise of common man survival from once routinely fatal diseases is rapidly increasing.
But new challenges and unfortunately, the severity of illness, the invasiveness of intensive therapies can make the Critical Care ( ICU) a brutal or unfavorable place for all involved – especially the patients and relatives.
Added to the new burden on the” new normal” – unpredictable nature of disease, restrictions, and isolation policies. Patients and families feel violations of their dignity and most survivors and family members experience symptoms of anxiety, depression, or post-traumatic stress disorder.
Thorough communication is the best tool that you have when your relative is in the ICU. Sometimes relatives are overwhelmed with information from many different people and teams. I often ask families if anyone is from a medical professional in their family so we can take them also in a loop which gives them a very positive transparent message.
Another thing that I ask relatives is to have someone with them. If you have a second set of ears to listen to what you are being told, then you can discuss it afterward to be sure that you heard everything that was communicated.
The Internet is not always the best resource. While looking up information on the Internet may be helpful for you to better understand certain things; the internet can be overwhelming because it has so much more uncalibrated information.
Nurses are excellent resources and can assist you in many ways. Nurses are the best patient advocates and help make sure that the right treatments and protocols for the patient are carried out.
Organising Multi-disciplinary ( MDT) family meetings
It is important to get frequent updates on how your loved one is progressing while in the intensive care unit. As discussed earlier, communication between you and the healthcare team is vital. However, when multiple teams of doctors, specialists are involved, patient is going through some very complex procedure, etc. – we make sure in our department that the family meeting is mandatory.
Multi-disciplinary family meetings help to given a chance for the healthcare team to give clear communication. At these meetings, all the consulting doctors, the patient’s primary doctor, nurses, critical care specialist, and other team members are in the room with the family. Instead of hearing one doctor’s views on the patient’s status, the family hears from everyone and leaves with a better understanding of how the patient currently is and the expected outcome.
Focussing on reducing Pain/Discomfort
Lying in a Critical Care ( ICU) bed for 90 – 100% of the day can be very uncomfortable. Add in the different tubes, drains, procedures, exams, and the procedures which happen in Critical Care(ICU) just compound the discomfort and pain. Teams make sure this is assessed by different scoring systems & assessment done by specific expert nurses to give them optimal treatment/medication or psychological sup to patients. Patient on the ventilator receives the scheduled or continuous pain relief and sedation medications while in the ICU.
Wish you a speedy recovery and good health.
Dr.Shailesh JhawarFRCA, CCST(UK)
Fellowship – Critical care & Cardiothoracic Anaesthesia (UK)
Apex Hospitals, Jaipur.