Intensive care unit patients' experience of being conscious during endotracheal intubation and mechanical ventilation

Abstract

The study suggests that clinical nursing practice may have to be further developed to accommodate the patients' needs, e.g. communicating and participating as well as optimizing nursing interventions towards thirst, pain and tube management. Furthermore, the intensive care unit setting may need revision, providing space for the patient and sensory meaningful inputs in the technologically intense environment.

Movements and trends in intensive care pain treatment and sedation: What matters to the patient?

“…A RASS level around −1 to 0 has been linked with favourable effects on a range of clinical outcomes (Barr et al, 2013;Devlin et al, 2018). According to several qualitative follow-up studies, more research is needed to understand how comfort may be maintained or protected during critical illness (Berntzen, Bjørk, & Wøien, 2019;Holm & Dreyer, 2017;Laerkner et al, 2017). Without monitoring patients' symptoms of pain and comfort measures continuously during the processes with titration of analgesics and sedatives, and by nonpharmacological interventions, patients may suffer.…”

“…Early mobilisation of patients receiving mechanical ventilation (MV) and the maintenance of cognitive function may explain the lower rates of delirium in the ICU (Denehy, Lanphere, & Needham, 2017). However, knowledge is limited about how critically ill patients tolerate staying awake while treated in the ICU and how these patients manage to rehabilitate after hospital discharge (Berntzen, Bjørk, & Wøien, 2018;Holm & Dreyer, 2017;Laerkner, Egerod, Olesen, & Hansen, 2017).…”

Implementing augmentative and alternative communication in critical care settings: Perspectives of healthcare professionals

“…For many patients being admitted to an intensive care unit (ICU) can be a traumatic, frightening and unfamiliar experience (Holm & Dreyer, ; Svenningsen et al., ; 2807–2815). Critically ill patients subjected to endotracheal intubation and therefore not able to speak often suffer from anxiety, stress, delirium, confusion, delusional memories and symptoms related to the post‐traumatic stress syndrome (Croxall, Tyas, & Garside, ; 800–804; Holm & Dreyer, ). Patients' lack of the ability to speak may lead to anger, anxiety and frustration among other things because many patients in the ICU are unaware of what has happened prior to admission and will have many questions and a compelling wish to communicate (Croxall et al., ; 800–804; Holm & Dreyer, ).…”

“…Critically ill patients subjected to endotracheal intubation and therefore not able to speak often suffer from anxiety, stress, delirium, confusion, delusional memories and symptoms related to the post‐traumatic stress syndrome (Croxall, Tyas, & Garside, ; 800–804; Holm & Dreyer, ). Patients' lack of the ability to speak may lead to anger, anxiety and frustration among other things because many patients in the ICU are unaware of what has happened prior to admission and will have many questions and a compelling wish to communicate (Croxall et al., ; 800–804; Holm & Dreyer, ). Exposure to high levels of stimuli in the ICU may entail sensory overload known to cause further problems for the patients such as irritability, headache, severe anxiety, hallucinations and confusion (Uzar Ozcetin & Hicdurmaz, ; 3186–3196).…”

“…2 | BACKGROUND 2.1 | Being awake and unable to speak For many patients being admitted to an intensive care unit (ICU) can be a traumatic, frightening and unfamiliar experience (Holm & Dreyer, 2015;Svenningsen et al, 2016;2807-2815. Critically ill patients subjected to endotracheal intubation and therefore not able to speak often suffer from anxiety, stress, delirium, confusion, delusional memories and symptoms related to the post-traumatic stress syndrome (Croxall, Tyas, & Garside, 2014;800-804;Holm & Dreyer, 2015).…”