ICU treatment justification

Hi Everyone,
Hope everyone’s pracs have started well! I have just started in ICU, and in the weeks leading up to it I was really intimidated and not really looking forward to working with people who could quite easily die at any moment. Fortunately our supervisor, the other physios, the doctors and the nurses are all really nice, and really accommodating-they are always happy to explain anything I don’t quite understand or to help me with my problem solving. In fact we have all been getting mini tutorials from different staff members about various conditions, surgeries, CXR’s etc, and it has been a very interesting learning experience so far.
Despite this I was almost completely put off on my second day after treating a very young patient, with a multitude of problems (multi-organ failure), with one of the other students. We had just done MHI for the first time, with inspiratory pauses, and half way through our treatment the patient had some ECG changes and her heart rate and BP dropped significantly. Our supervisor told us not to do the inspiratory pauses anymore but to keep going with bagging. After we finished treatment the nurse said the patient had had an ischaemic episode whilst we were bagging-which in such a sick patient was a big deal! Three hours later the patient suffered complete heat block and there was nearly a code blue.
Even though this happened a number of hours after our treatment I couldn’t help but think that it was our treatment that caused it to happen, especially since it was the first time I had every bagged someone!
The next day I talked with the supervisor and the nurse, both of whom were very nice and explained that it was not out fault, since the patient was so sick and had such poor cardiac function that it didn’t matter who bagged her it would have had the same effect. There were indications that it needed to be done, and we couldn’t not treat her just because she was at risk of complications from the treatment, it was the same as with patients who have an elevated ICP-we have to decide whether the need for treatment is greater than the risk of causing adverse effects.
The ICU is a very high pressure environment, and the patients are all very unwell, however they also all need physio treatment, we just need to have justification for our chosen intervention, and be ready to deal with the consequences. We need to be confident in what we are doing and why we are doing it, and as long as we are careful to limit any possible negative effects then there is no reason to not treat someone. Just look carefully at the situation, and try to remember that what you are doing is most likely going to have a positive effect and going to aid their recovery.
Our patient is still in the ICU, and very, very unwell but at least they are still alive!