#Intensive Care Unit

[tmedic]

ICU & ED simulation training -challenging but great experience!💪

[chloroformcurry]

I.C.U., Pandora

[liaperaza]

From a little over 4 years ago. I was in a serious motorcycle accident, killed my girlfriend who was riding with me and nearly killed as I was brought back twice. I was in the hospital for almost 4 months, with 5 weeks of that in ICU. My left was amputated above the elbow because of the accident. Due to severe internal injuries, had to have colostomy. The colostomy just got reversed in April. Been a long road, but thankful and very lucky to be alive

[were-my-demons-hide]

I am an occupational therapist working at a hospital. We are fighting for better working conditions to FINALLY get some relief. All the pressure and distress is captivating and harmful for all of us. Nurses, doctors, therapists, and every single person working in the german health care system. We could do so much better if the system would let us. But we need fair payment, more employees, and a fucking personal life.

And I feel hope. I really do. I am willing to fight for a better future. And we will fucking get it.

[kenniegeex2]

Today my patient crashed and burned. He went from awake to unresponsive, with a very low BP, actively bleeding, and unable to breathe on his own. I did so many things to keep him alive, including being covered in his blood and donor blood, until they could take him to surgery to stop the bleed. I took him off the ventilator several hours later and he grabbed my hand and kissed it (his baseline mental capacity is the same as a 10 year old). His sister and brother thanked me profusely for saving his life. I’m bone tired, I haven’t eaten since yesterday, and fuck I’d do it all again in a heartbeat.

[raysberries]

Writing hospitals

Experiences of someone recently been at an intensive care unit, having gone through the ER

About my situation: This happened in a European country with free healthcare, didn’t involve an ambulance ride and I’m a minor, so not everything will be applicable to everyone

Admission process

It’s not always easy to find the right entrance, sometimes it’s not even walking distance

Walk of shame to the desk to explain what’s wrong (especially if it’s late at night/it’s busy)

Having to wait in silence in a room for a nurse/doctor (and not knowing for how long you’ll have to wait, depends on how urgent it is)

Having to answer private questions and your answers being written down, if someone took you to the ER they may be asked to leave the room if you prefer

Talking to so many different people, having to repeat yourself a lot, many of them you’ll only see once

At the intensive care unit

IV pulling uncomfortably when you move your arm (not being able to sleep easily)

Regular (maybe one hourly) blood pressure taken (the device around your lower calve most of the time)

It’s never really silent (always beeping and moving)

Never being really dark (monitors and hallway lights)

Having to wait for (and not knowing exactly when you’re gonna see) a doctor or anything really, nothing is every really „scheduled“ if it’s not life threatening

Having to pee in a bed pan if you’re not allowed/able to stand up (and the whole process around it like calling for a nurse to bring the pan and take it away), most humbling experience

So many blood tests, they may not find a suitable vein on the first try

Puking in a plastic bag (and everyone hearing it)

Your vitals being tracked at the monitoring station (and alarms going off there alongside your monitor)

Your heart rate possibly outing your feelings (a raised one indicating stress for example, embarrassing)

Finger clipped in, not being able to use it

A remote with a red button to call a nurse (attached with a cord to the bed)

A remote to change the bed position

A TV may exists though channels are limited, if the remote falls it’s a pain

Possibly no socket in immediate reach

Probably no Wi-Fi (at least on the childrens’ ward)

Having to be clipped off and on to the machines after standing up (and how uncomfy it is for them to reach under the gown)

The gown being comfy but also open back so your whole ass hanging out while you move around (though you could possibly wear your own clothes but the tubes may interfere with them, I preferred to wear the hospital gown)

Feeling sticky (since you’re not really able to shower for however long, though you might get a disposable cloth and warm water to freshen up a bit and toothpaste and such)

Hospital food, not as bad as I thought though very plain and not always warm when it arrives

Maybe getting visited but spending most of your time by yourself

Visits being strange and feeling pitied

Only one visitor being allowed in at a time (COVID policies like that and a mandatory mask and current Covid test)

Having to share a room since there’s not enough space to have a private room (on childrens‘ ward possibly even with infants, their parents being there constantly and it being pretty awkward, especially when they have nap time)

Release and aftermath

Getting released even when you’re not totally recovered, they just don’t have enough space/people to keep you there

Paperwork to be signed when released (either by you or your guardian)

The hospital scent clinging to you, the relief of finally washing it off and the familiar scent of home

Taking the toothpaste (and toothbrush) with you since they gave it to you and it would’ve thrown it away if you left it there

Marks from the EKG on your chest not washing off immediately, being reminded of the experience every time you shower (for me it took over three showers to wash off)

IV mark not fading fast (very noticeable for up to a week, not totally faded even after two) + the marks from blood tests

Dealing with the missed time, possibly having to make excuses for your absence and dealing with indiscrete people (your doctors note indicates a hospital stay so you can’t hide it completely at your school or work place)

Choosing to keep your stay to yourself and almost forgetting you didn’t tell them, feeling alone in your experience since talking about it may be difficult and you don’t want pity so bottling it up may be your path of choice

That’s everything technical about the experience that I could come up with, there’s much mental stuff to talk about but that differs even more

[sahayoghospital]

Sahayog Hospital Pioneering Specialized Healthcare Excellence in Gondia

In the heart of Gondia, Maharashtra, Sahayog Hospital stands tall as a best hospital in gondia beacon of hope and healing for the community. With a steadfast commitment to providing exceptional healthcare services, Sahayog Hospital has emerged as the premier destination for specialized medical care in the region. From advanced brain and heart care to a wide array of super specialty services, the hospital is dedicated to ensuring superior clinical outcomes and patient satisfaction.

[bereavedmum]

Transfer to ICU

Written sitting in corridor outside ICU Leah continued to find breathing difficult and has now been transferred to the Intensive Care Unit. Nic & I are in the relatives waiting area & have been told that it will be 30 or 40 minutes before we’re allowed to see her. I’m not used to being separated from Leah when she’s ill and I’m finding it very difficult – I feel that my role as a mother is to be…

[metausa23]

The Roles of Medical Interpreters in intensive care unit Communication

Effective communication is the cornerstone of quality healthcare, and nowhere is this more critical than in the Intensive Care Unit (ICU). The ability to convey accurate medical information in a timely and culturally sensitive manner can make a significant difference in patient outcomes. In this blog, we explore the indispensable roles of medical interpreters in ICU communication, shedding light on the challenges we face, their impact on patient care, and the evolving landscape of medical interpretation.

Introduction

In the fast-paced world of healthcare, where every second counts, effective communication is a non-negotiable element. The ICU, being a high-stakes environment, demands precision in information exchange. Medical interpreters play a vital role in ensuring that language barriers do not impede the flow of critical information between healthcare professionals and patients.

Understanding the Intensive Care Unit (ICU) Environment

The ICU presents unique challenges, including high-stress situations, emotional conversations, and rapid decision-making scenarios. These factors underscore the need for clear and concise communication. In this section, we delve into the intricacies of the ICU and why accurate information exchange is paramount.

The Significance of Medical Interpreters

Medical interpreters act as linguistic bridges, facilitating communication between patients, their families, and healthcare providers. Their role goes beyond mere translation; metaphrasis ensure that the nuances of language and cultural context are accurately conveyed, minimizing the risk of misunderstandings that could have severe consequences.

Key Skills of Medical Interpreters

To excel in their role, medical interpreters need a unique set of skills. Proficiency in multiple languages, cultural competence, and a deep understanding of medical terminology are essential. This section explores these key skills and their importance in the demanding field of medical interpretation.

Challenges Faced by Medical Interpreters in the ICU

Working in the ICU presents a set of challenges for medical interpreters. We must navigate high-stress situations, emotionally charged conversations, and make split-second decisions. Overcoming these challenges requires resilience and a deep commitment to their role in facilitating effective communication.

Impact on Patient Care

The influence of medical interpreters on patient care cannot be overstated. By ensuring that patients understand their diagnoses, treatment plans, and follow-up care, interpreters contribute significantly to improved patient outcomes. Additionally, we play a crucial role in reducing the likelihood of medical errors that can arise from miscommunication.

Collaboration with Healthcare Professionals

In the collaborative environment of the ICU, medical interpreters work closely with healthcare professionals to ensure seamless communication. Their teamwork with nurses, doctors, and other staff members is vital in providing holistic and patient-centered care.

Training and Certification for Medical Interpreters

Recognizing the specialized nature of their role, medical interpreters undergo rigorous training and certification programs. This section explores the importance of such programs in equipping interpreters with the necessary skills and ensuring adherence to professional standards.

Technological Advancements in Medical Interpretation

Advancements in technology have revolutionized the field of medical interpretation. Telemedicine and remote interpretation services have become increasingly prevalent, expanding access to interpretation services and overcoming geographical constraints.

Success Stories of Effective Communication

Real-life examples demonstrate the positive impact of effective communication facilitated by medical interpreters. These stories highlight instances where clear and accurate interpretation led to improved patient satisfaction, better adherence to treatment plans, and overall enhanced healthcare experiences.

Legal and Ethical Considerations

Navigating legal and ethical considerations is an integral part of the medical interpreter’s role. Confidentiality in medical interpretation and adherence to ethical standards are crucial to maintaining trust between interpreters, healthcare providers, and patients.

Future Trends in Medical Interpretation

As technology continues to advance, the role of medical interpreters is evolving. Integration of artificial intelligence and continuous improvement in interpreter services are shaping the future of medical interpretation, ensuring that it remains a dynamic and responsive field.

Feedback and Evaluation Process

Ensuring the effectiveness of medical interpretation involves establishing robust feedback and evaluation mechanisms. Healthcare institutions must assess the quality of interpretation services, identify areas for improvement, and implement strategies to enhance overall communication.

Cost-Effectiveness of Utilizing Medical Interpreters

While there may be associated costs with implementing interpreter services, the long-term benefits for healthcare institutions far outweigh the initial investment. Improved patient outcomes, reduced medical errors, and enhanced patient satisfaction contribute to a positive return on investment in medical interpretation services.

Conclusion

In conclusion, the roles of medical interpreters in intensive care unit communication are pivotal to the delivery of quality healthcare. Their ability to bridge language gaps, navigate challenging scenarios, and contribute to collaborative care makes them indispensable in the healthcare ecosystem. As we move forward, the need for effective communication will only grow, emphasizing the ongoing significance of medical interpreters.

[insidecroydon]

Hospital's £15m intensive care unit is open for treatment

A £15million state-of-the-art intensive treatment unit at Croydon’s largest hospital received its first patients this week. New team, new ITU: staff have praised the £15m new intensive care unit at Mayday Hospital With 22 beds for Croydon’s most critically ill individuals, the ITU opened on Monday at Croydon University Hospital. The new unit has doubles the space available, which allows patients…

[banglakhobor]

হিট স্ট্রোকে আক্রান্ত, দুবাইতে হাসপাতালের ICU-তে রয়েছেন অভিনেতা রাকেশ বাপাট

‘হিটস্ট্রোক’-এ আক্রান্ত ‘তুম বিন’ অভিনেতা রাকেশ বাপাট। গুরুতর অসুস্থ অবস্থায় তিনি দুবাইয়ের একটি হাসপাতালে ভর্তি রয়েছেন। এই মুহূর্তে তিনি হাসপাতালের ICU-রয়েছেন বলে খবর। মঙ্গলবারই রাকেশ বাপাট ইনস্টাগ্রাম হ্যান্ডেলের মাধ্যমে নিজের অসুস্থতার খবর শেয়ার করেন। মঙ্গলবার রাকেশ বাপাটের সোশ্যাল মিডিয়ায় যে ছবিটি পোস্ট করা হয় তাতে তাঁর হাতের একটি ছবি ছিল। যেখানে দেখা যায়, অভিনেতাকে চ্যানেলের মাধ্যমে IV…

[sparshhospital3]

Sparsh Hospital - Providing World-Class ICU Care for Patients

Sparsh Hospital in Panvel offers world-class ICU facilities with state-of-the-art equipment and a team of highly skilled doctors and nurses to provide the best possible care to critically ill patients. Trust Sparsh Hospital for the best ICU treatment and recovery.

[daytonicuconsulting]

How Clinicians, Patients, and Families Can Benefit from Better Communication in the ICU

Back when I was studying to become a nurse, I had an experience in the ICU that changed me forever.

As a starry-eyed 18-year-old nursing student, I was incredibly excited to finally be in the ICU, experiencing what I’d dreamed about for so many years.

But when I got there and started to learn what ICU culture is really like, it broke my heart.

At the time, I was pretty chatty, not least because of how excited I was, and the nurse I was shadowing definitely wasn’t a fan.

Eventually, she turned to me and said, “I work here in the ICU so I don’t have to talk to anyone. So, if you’re thinking this is going to be your social hour, you’re wrong.”

Now, I’m not saying that all ICU clinicians are like this, but this is the kind of attitude that ICU culture tends to create, and over the years, not much has changed.

The fact is most ICU clinicians are taught that the most humane thing they can do for patients is to keep them heavily sedated, and as a result, communication in the ICU between clinicians and patients is almost non-existent, as the patients are usually comatose.

But the truth is avoiding communication in the ICU isn’t in anyone’s best interests, and for the most part, keeping patients heavily sedated actually does more harm than good.

Among other things, these practices make clinicians’ jobs harder, erode the health and autonomy of patients, and preclude family involvement.

So, in an effort to set the record straight on communication in the ICU, I wanted to publish an article exploring why this aspect of ICU patient care is so broken, how these shortcomings can affect everyone involved, and what clinicians can do to improve ICU communication.

If you’d like to learn more about communication in the ICU, you can check out Episode 103 of my Walking Home From The ICU podcast.

Why Is Communication in the ICU so Broken?

When I work with ICU teams to help them improve sedation and mobility practices, I find that most ICU clinicians are pretty much lost when it comes to communication.

Often, they’ll ask me questions like, “Okay, now they’re awake. How do we do this?” offering a poignant reminder of how ill-equipped most clinicians are when it comes to communication in the ICU.

But why is this?

Well, aside from the prevailing ICU culture, which teaches clinicians that the best thing they can do for their patients is to keep them heavily sedated, clinicians just aren’t given the training or tools they need for effective communication in the intensive care unit.

For the most part, ICU clinicians don’t expect to have to converse with patients because they’re all too sedated to communicate.

Moreover, ICU teams are not used to taking the patient’s input into consideration when assessing them, or in any way involving them in decisions about the care they’re receiving.

This changes the way that clinicians view their patients, and has a demonstrably dehumanizing effect, as the patient’s wishes aren’t even taken into consideration, much less solicited.

For example, many nurses aren’t even aware of the importance of having a whiteboard or pen and paper in each room, let alone knowing they can contact those who work in speech therapy for help.

As a result, speech therapists typically only come to the ICU to do swallow evaluations after patients have been extubated. And rarely, if ever, are they called in to help clinicians with communication issues.

Why Is Communication in the ICU so Important?

The United Nations Universal Declaration of Human Rights states that communication is a basic human right, but that only scratches the surface of why communication in the ICU is so important.

For a patient, effective communication in the intensive care unit means everything, as it allows them to have autonomy, dignity, control, connection, and comfort.

At the same time, it keeps them cognitively engaged, helps to prevent delirium, and allows them to be properly informed, have their wishes respected, and communicate their spiritual, physical, and emotional needs.

For families, communication in the ICU allows them to converse with and comfort loved ones, and avoid situations where family members have to make life-changing decisions on behalf of patients without their input.

As a clinician, knowing how to effectively communicate in the ICU just makes everything easier, and mitigates the dehumanizing effect of ICU culture.

It allows you to take less time to assess patients, improves patient safety and compliance, and gives you the chance to develop relationships with patients and build trust by answering their questions and helping them to understand the situations they face.

What Are the Consequences of This Lack of Communication in the ICU?

Lack of communication in the ICU can create dire consequences for clinicians, patients, and their families.

If you’re a patient, this lack of communication can result in trauma, frustration, anxiety, agitation, and delirium, and it also results in patients dealing with unmet needs and suffering from undiagnosed changes.

For example, one of my podcast listeners shared an anecdote with me about one of their patients.

This patient was intubated, but the ICU where they were being treated chose to adhere to evidence-based practices and kept them awake while on the ventilator.

And because they were awake, the patient was able to tell them that they were having chest pain.

At this point, they went ahead and did an x-ray on the patient’s chest, only to find out that they had a pneumothorax. Then, as they were looking at the x-ray, the patient went into respiratory arrest and their heart stopped.

This shows just how important communication in the ICU is, because as a result of the patient being able to communicate, clinicians knew there was something wrong, and were able to find out what it was by taking an x-ray.

More importantly, this also allowed them to save this patient’s life.

But if they’d been unable to speak, clinicians may have never known anything was wrong, wouldn’t have thought to take an x-ray, wouldn’t have known what was causing the patient’s respiratory arrest, and it may have been too late for them to do anything.

At the very least, even if they were able to save the patient, they would have wasted a lot of time figuring out what was causing this to happen. This would have made everything more difficult, not least because it would significantly reduce the patient’s chances of survival.

This lack of effective communication in the intensive care unit can also create serious consequences for patients’ families, as they may have to make gut-wrenching decisions on their behalf, and are otherwise unable to communicate with them during what could be the last moments of their life.

Last but not least, this lack of communication in the ICU can also pose serious problems for clinicians.

For instance, if patients are unable to communicate, it will take much longer to assess them, and this can result in a ton of frustration for clinicians, who have many other patients to see, and don’t have a lot of time to deal with this sort of thing.

This also creates a situation where clinicians will be more inclined to sedate patients, as they’re more likely to become agitated when they can’t communicate, and this makes working conditions less safe.

Furthermore, this all perpetuates the idea that patients can’t be awake and calm on the ventilator, which is one of the things about ICU culture that we desperately need to change.

When it Comes to Communication in the ICU, What Needs to Change?

First and foremost, if we want to improve communication in the ICU, ICU culture needs to change, along with the mindsets of those who work in the ICU.

Instead of avoiding communication with patients, and clinging to the erroneous belief that this makes our jobs easier, we need to fight for patient autonomy.

If we ever want to get out of the situation we’re currently in, these are the kinds of ideas that need to prevail in ICU culture.

ICU clinicians need to be much more concerned with the best interests of the patient, rather than just focusing on what they know, what they’re most comfortable or familiar with, or what’s most convenient for them. And they need to realize that this lack of communication only makes their jobs harder.

At the same time, if families get more engaged and involved with what’s happening to their family members in the ICU, things are bound to change.

Families should demand that their loved ones be able to communicate, and oftentimes, they’re the ones who’ll have to sit there and spend whatever time is necessary to figure out what they’re trying to say and what they want, so family involvement is also key to the resolution of this issue.

What Can Clinicians Do to Improve Communication in the ICU?

I know this seems daunting, but the truth is there are several simple solutions that can be employed in every ICU to improve communication with patients.

Here are some things I like to recommend to ICU clinicians who want to improve their communication:

VidaTalk – This app allows clinicians to communicate with non-verbal patients or those who are otherwise dealing with communication barriers. This software is also a reimbursable intervention, and for each patient who uses it, your hospital can get $1,000 through Medicare or Medicaid.

Paper, pens, and pencils – One of the most effective ways to communicate with non-verbal patients is to allow them to write things down. They may not seem like much, but these items can have a huge impact on communication in the ICU.

Whiteboards or Boogie Boards – Paper takes up a lot of space, and if you’re using a lot of it, it can get expensive. With that in mind, these items offer a great alternative to communicating via pen and paper.

Laptops, tablets, or cell phones – These kinds of devices are absolutely invaluable when it comes to non-verbal communication, so it’s always good to have at least a few on hand in your ICU.

Passy Muir valves – These valves allow patients with tracheostomies to talk by redirecting airflow through the mouth, nose, and vocal folds.

Do you want to improve communication between patients and clinicians in your ICU? We can walk you through the entire process, so please don’t hesitate to contact us.

[were-my-demons-hide]

I am an occupational therapist working at a hospital in multiple intensive care units. And today I had a day full of both:

huge progress towards recovery and death.

[jppres]

Drug utilization in patients with SARS-CoV-2 in an intensive care unit

Image: Flickr Article published in J. Pharm. Pharmacogn. Res., vol. 10, no. 6, pp. 977-985, November-December 2022. DOI: https://doi.org/10.56499/jppres22.1460_10.6.977 Miguel Sevilla Méndez1, Ana M. Téllez López2, Giovanni Gómez Barragán3, Ivette Reyes Hernández2, Claudia Velázquez González2, Isis B. Bermúdez Camps2* 1Departamento de Servicios Farmacéuticos y la Unidad de Cuidados Intensivos…