Patients’ Experiences of Waking up in Intensive Care
Intensive Care can be perceived as somewhere you will only find yourself if you are very sick. I invited GUCH patients and their relatives to share their memories of the intensive care units (ICU) around the country to provide an insight into this unique experience. Those with whom I spoke to found it a deeply nurturing and, as the name suggests, caring environment, providing vital reassurance in the crucial hours following surgery.
The majority of GUCH’s who find themselves in intensive care due to their heart condition, will do so as a result of planned surgery. Patients can, if they wish, read leaflets, which explain everything from mealtimes and protocol to the doctors’ ward rounds. The patients I spoke to commented that this, and the opportunity to visit ICU with their relatives, helped to dispel some of the mystery and uncertainty and that they found the staff incredibly reassuring and caring, something which continued throughout their time in ICU. One patient preferred not to read anything, nor did not want to visit ICU before her surgery, and said she was glad she didn’t, which is also fine.
The patients’ memories of ICU tended to be hazy due to them being heavily sedated and drifting in and out of sleep. Their immediate feelings on waking up and finding themselves in intensive care were generally relief, gratitude, and even surprise, at having got through the surgery. One patient recalled waking up panicking and trying to get off the bed, but that staff were on hand to provide reassurance, something that others also remembered with gratitude. Patients remembered their relatives talking to them, which they found comforting and reassuring, even though most could not recall what they said and were too tired to respond.
Another early memory was of the ventilation tube, drips in the hands and neck, which can feel unpleasant, and, if a pacemaker is due to be fitted, pacing wires sticking out of the chest. One patient explained that the ventilation tube was removed earlier than usual as she had woken up coughing and attempting to rip the tube out. Once the tube had been removed, she happily went back to sleep but was closely monitored. She remembers intensive care as a positive experience; “I felt cocooned by all the one to one monitoring and reassured that everyone seemed to be smiling and nodding when the doctors came round”. A mother, describing her first experience of visiting her daughter in intensive care, said “it was strange seeing her with lots of tubes but it helped to see her out of theatre, recovering and being so well cared for”.
Early on, patients remember being encouraged to sit up and get out of bed and that this was the last thing they felt like doing, still feeling exhausted and wanting only to sleep.
Patients explained that as each day went by, they gradually became more aware of their surroundings and what was going on around them. They recalled the various tubes and catheter being removed, as they were able to get out of bed and walk to the bathroom and felt reassured that they were making progress.
Experiences of pain relief varied. One patient enjoyed being on morphine, particularly as she was well enough to control it herself. For another, it caused nausea, vomiting and disorientation, which she found distressing. She asked to come off the morphine due to experiencing these effects and disliking the dissociation. This meant that she was more aware of what was going on around her but experienced more discomfort, particularly when the chest drains were removed.
Leaving ICU heralds the start of recovery and getting back to “normal”. Patients reported being glad to move away from the noise of the machinery and constant light in intensive care, which made sleeping difficult as they began to recover. Some felt anxious about leaving the environment in which they had received such intense care and attention, but this will only happen when you are well enough to leave.
It is understandable to feel concerned about surgery and what will happen afterwards. However, the patients I spoke to recalled their time in ICU with affection and gratitude towards those who cared for them.
Your cardiac liaison nurse can provide more information if you are concerned about intensive care. Help and advice is also available through the GUCH message board, www.thesf.org.uk, helpline 0800 845 759 or e-mail firstname.lastname@example.org and Anne Crump, mental health support worker 0808 240 1165 or e-mail email@example.com
For more information about Intensive Care, visit the Intensive Care Societyhttp://www.ics.ac.uk/
With grateful thanks to the members who were willing to share their experiences of intensive care and their time in providing thoughtful and honest accounts of their experience.