In the first few days of their admission many patients are kept sedated with a mixture of sleep inducing and pain killing medications. Some of the life-saving treatments required in ICU are uncomfortable or unpleasant and the sedation makes this more bearable for the patient, as well as allowing them to rest. They might not remember this time.
As they improve their sedation will be reduced to allow them to become more aware of their surroundings. It can be frightening to wake up in a strange place and it can take some time for the sedative drugs to wash out the patient’s system. They often find the presence of family and friends reassuring at this time.
Some patients get better quickly and are soon ready to leave the ICU, for others the process is more prolonged and they may require support, particularly from the ventilator, or breathing machine, for some time. This slow recovery process is often called ‘weaning’ and although the patient is on the mend they can find this time very frustrating as their progress is slow, and they may not be able to talk, eat or drink. Again the presence of family and friends is helpful to boost the patient’s morale, and access to TV, music, photos, clothes and toiletries from home all help. Mobilisation by the physiotherapy team at this time is vital in helping the patient regain the strength and co-ordination of their muscles.
Some units make ‘patient diaries’ for their long stay patients, with photos, comments from staff & visitors, news, and cards. Patients often feel they have ‘lost’ the days they were unwell and the diaries are useful for filling in the gaps.
In the high dependency unit patients are less likely to be sedated, and so are able to communicate, eat, drink and read. Although they may still be worried about their problems they are usually less disorientated.