“Love, during a serious illness in the ICU”


“Love, during a serious illness in the ICU”

Citation:

Santiago Herrero. Love, during a serious illness in the ICU.  Journal of earls in Intensive Care Medicine 2011. Volumen 1. Nº 24  http://wp.me/p19kQl-bW

Introduction

La Unidad "B" de Cuidados Intensivos del Hospital de Cabueñes
Unit “B” Intensive Care Hospital Cabueñes

All imagine losing a family member, that means dying to join in an ICU, is a painful and always turn to a friend or close relative like a father, mother, brother or husband or even as a a wife for comfort.
However, the UCI closer than filial love or friendship, what it does is get away from these people, perhaps only by the instinct of “functional work” of the UCI …
I think it’s a mistake!
My experience tells me that love can move mountains, but in critically ill patients, that love is magnified because the feeling of loss is constant, while the patient remains in a critical care situation!

Doctors do not just magnify the situation “desperate clinic” for patients when entering or during their evolution. The medical information is supposed to “true” and reported that a patient in critical condition, has many “possibilities” of clinical worsening, since these are in a “dynamic phase”. What does that mean?
Dynamic is a word very commonly used by intensivists, and means “time evolution of a process in relation to the causes of changes in a physical and / or state of motion.”

But, how is the process of patient after your ICU admission?

When someone very serious in the ICU after an initial patient contact with his family, which usually lasts a few minutes (just be aware or not), it is isolated from the family environment, to perform the actual work that we assumed (and you really do, in fact just our department has had no complaint of it) and is independent of the patient’s prognosis (the patient can live or die depending on the injuries to).
These patients after admission, hemodynamically stable or not, live a life of isolation especially personal, family disconnected, disconnected from their loved ones and by far “professional love” never be treated like family.

Our work in the ICU should not isolate patients from their families (except the time of clinical performance) … The reason is that “there is a clear loss of the feeling of love” …

Our mind and physical body … indelibly go together and the UCI, unfortunately separates them. Patients are contacted only a few hours (2-4 hours a day with families) and from my point of view this is a “serious interruption of the communication.”
A patient does not get worse because the patient more time with his family. The trip times of nursing with the patient may make families come out, but after that contact should be maintained, even with patients in a “coma”!

The term “open UCI” is well known, mainly in “America.” Spanish ICUs are “closed ICUs” perhaps too tight. Probably the nurse and doctor are comfortable, but the patient does not have the “heat of the family,” disappears “filial love or staff in the most tragic moment of his life”

Personally during my stay there (Houston) saw the “Pro” and “Con” open ICUs. The term “ICU” in the U.S., is also very different from the “Spanish” by the way they work (mostly medical) is much more positive as the “Spanish” about “efficiency” shown in several medical journals of quality of care ( and why even some insurance Americans prefer our more hierarchical system of intensive care and continuity of care assumed by the professional) …

However, the open ICU system, I think it is good for the patient from the standpoint of “soul.” The patient is accommodated in the Box from the ICU, but in contact with a family permanently, except in moments of “crisis” when physicians should make clinical therapeutic action. The patient receives the “warmth of the immediate family” and may feel more relaxed (although no clinical studies on it). “Love, during a serious illness in the ICU” can be maintained even when the patient loses consciousness!. While the patient may or may not “love” at the time of unconsciousness (as yet untested) the effect of the relative comfort is an act of good fortune.
In addition to changes in hemodynamic status may be more beneficial when the patient knows that the family is by his side. It’s hard to believe that the benefit would not be therapeutic, but probably mental.

ICUs open or closed but with a structure “ajar”. I support this last idea would probably be very “costly” for the center and very beneficial for the patient, his family and “Love.”

Citation:

Bibliography

  • Pronovost PJ, Angus DC, Dorman T, Robinson KA, Dremsizov TT, Young TL. Physician staffing patterns and clinical outcomes in
    critically ill patients: a systematic review. JAMA. 2002; 288:2151-62.
  • Pronovost PJ, Jenckes MW, Dorman T, Garrett E, Breslow MJ, Rosenfeld BA, Lipsett PA, Bass E. Organizational Characteristics
    of Intensive Care Units Related to Outcomes of Abdominal Aortic Surgery. JAMA. 1999;281:1310-7.
  • Rockeymoore MB, Holzmueller CG, Milstein A, Dorman T, Pronovost PJ. Updating the leapfrog group intensive care unit
    physician staffing standard. J Clin Outcomes Manage. 2003: Jan;10(1):31-37

Citation:

Santiago Herrero. Love, during a serious illness in the ICU.  Journal of earls in Intensive Care Medicine 2011. Volumen 1. Nº 24  http://wp.me/p19kQl-bW

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Santiago Herrero

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Journal of Pearls in Intensive Care Medicine - Perlas en Medicina Intensiva

Herrero-Varon's MD Editors. Asturias (Gijón) and Houston (TX, USA). Languaje EN/ES 2011-2016

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