I am on an ICU cardio placement and the large number of intubated patients has raised some interesting points.
Most intubated patients have either a trache or an ETT- which means they cannot talk, even if they are not sedated. A lot of the patients are sedated, but to varying degrees.
Last week I was asked to see a patient who had just been extubated following cardiac surgery. The patient was awake and able to talk- so I did my assessment and treatment as necessary. For an intubated patient, there is always a nurse in the room or very close by, but not always for extubated patients. When the nurse left the room, the patient expressed to me how horrified he was the previous day when he was still intubated- and a team of about 5 or 6 doctors and nurses stood around his bed looking at the instruction manual for his ventilator. Of course he could not say anything to the doctors, and they probably didn't even realise he was awake.
Although the patient in this case was joking about it when he relayed the story to me, it does highlight an issue that is important in this setting- constantly communicating with the patient what is going on, even if they are sedated and may not hear what you are saying. You just never know how awake they may be! I'm sure if the doctors had explained what they were checking and why, the patient could have been put at ease.
Subscribe to:
Post Comments (Atom)
1 comment:
I remember having the same observation! It may feel odd to talk to a patient who appears to be asleep. But you have definitely highlighted how it can go a long way to reassure the patient. I remember one thing I really felt… The lack of communication with your patients. Your subjective consists of asking the nurse how the patient has been. “Have they been coughing, Has there been a lot of sputum…” It can feel quite daunting. But you’re right, putting the patient at ease is important.
Post a Comment