Health care inequality in critical care medicine is multifactorial and negatively impacts patient outcomes [18]. During COVID-19, for instance, it was noted that Hispanic patients were more at risk of having severe COVID-19 infections, and despite their younger age, they had a higher mortality rate. Socioeconomic disparities, lack of access to health care, timing, and
How the ABCDEF Bundle Can Help Mitigate RN Burnout
Nurses enter critical care medicine to alleviate human suffering, support patients in their most vulnerable moments, be patient advocates, do no harm, and save lives. But being a critical care nurse is physically, emotionally, and mentally challenging. Many factors have resulted in the loss of thousands of expert nurses, creating the staffing crisis we’re currently
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How ICU Staffing Ratios Relate to the Awake and Walking ICU Approach
The Awake and Walking ICU approach is deeply rooted in science, pathophysiology, and logic. Yet some of the best fruits of this method are humanity, compassion, dignity, and love. We use this approach to humanize the ICU, and I believe that is a desire of most ICU clinicians. But the reality is, no matter how
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The Financial Benefits of the ABCDEF Bundle
The ABCDEF Bundle is easily the best tool we have to improve patient care and outcomes in the ICU. If you know anything about these evidence-based practices, you’re probably well aware that they can decrease length of stay and readmissions, and reduce patients’ chances of dying, while making it more likely that they’ll return to
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Patients and Their Families Have the Right to Know the Risks of Sedation
Patient autonomy is a pillar of clinical ethics, and it’s vital to the integrity of any clinical practice. Observance of this principle works to uphold patients’ rights, fosters trust and collaboration, respects diversity, and empowers individuals to actively participate in decision-making regarding their healthcare. In our efforts to protect patient autonomy, one of the best
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ICU Rounding Culture: What Needs to Change and How We Can Help
One of the biggest barriers to improving ICU patient care is a lack of interdisciplinary collaboration, especially when it comes to ICU rounding. In theory, rounding should give clinicians the opportunity to review and discuss each patient’s care, and then come together to ensure that care is a reflection of best practices and the patient’s
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Unplanned Extubations: Dispelling the Fear and Understanding the Reality
When I think back to how I started my career as a nurse, it really does seem like a date with destiny. I could have gotten a job at any ICU, but for whatever reason, I landed my first nursing gig at a high acuity medical-surgical intensive care unit in Salt Lake City, Utah, which
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How Simulation Training Can Help to Improve ICU Patient Care
Despite many exciting advancements in technology and research, ICU sedation and mobility practices continue to be stuck in the past. A big part of this problem stems from ICU culture, which encourages clinicians to fear change and be resistant to new ideas and approaches. But regardless of these issues with ICU culture, the truth is,
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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
As far as the early mobility community is concerned, the benefits of early mobility in the intensive care unit are not up for debate. There are mountains of evidence to show these benefits and support the safety and efficacy of early mobility in the ICU, and this is something I’ve documented repeatedly. But unfortunately, ICUs
My dad came down with COVID pneumonia at the end of September. We did our best to treat him at home but eventually we realized we needed to get him to a hospital. After about four days in the hospital on oxygen he crashed and needed to be put on a ventilator. We were devastated.
When they put a person on a ventilator, hospital protocol generally is to sedate and paralyze the patient. My dad was sedated and paralyzed for a total of about 17 days. He was completely immobilized. One doctor told us that my dad had one of the worst cases of COVID pneumonia he had seen in a long time. We were, of course, extremely worried. As time went on, his condition worsened. Through a series of miracles, my dad stabilized enough that they were able to give him a tracheostomy. This was the turning point where he was able to get transferred to a LTAC facility (which is a critical care facility for COVID patients).
Fortunately, through a friend, we were put in touch with Kali Dayton. We were told she has had amazing success helping people come down off sedation and the paralytic. One of the side effects of sedation is the patients experience extreme delusions and hallucinations. While we were at the LTAC, Kali was extremely helpful in helping us understand the importance of getting my dad off the paralytic and sedation quickly. She informed us that every day he was on the sedation added weeks onto his recovery. We began pressuring the staff at the LTAC to get him off the sedation. Kali has found that it is critical to get a ventilated patient up and moving and you can’t unless they are off sedation. The staff at the LTAC were very hesitant to take my dad off sedation, at times even telling us he was off it, when in fact, he was still on sedation.
Heidi Lanthen
Utah, USA
Perception Versus Reality: Debunking The Myths About Medically-Induced Comas
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