In this week’s blog I want to talk about the big issue of depression for long- term ventilated Adults& Children with Tracheostomy and their Families in Intensive Care.
Anybody working in Intensive Care has seen the situation over and over again that long-term ventilated Adults& Children with Tracheostomy are facing, as soon as they realise their massive dilemma. Because they are stuck in Intensive Care with no Quality of Life, they are depressed and they are desperate to get out of Intensive Care.
Dependent on other people, with no privacy, no dignity and with no Quality of Life, the long-term ventilated Patients are often left in a side room, often with no natural daylight,(many ICU’s lack natural daylight) maybe with an agency nurse or a junior nurse looking after them, because the more experienced and the more senior staff are busy looking after more acutely unwell Patients. The ward round might often see long-term Patients last, because there are more urgent things to do in an ICU and besides, there is not much progress with the “long-termer” anyway. Maybe the “long-termer” has caught an infection in the meantime and is now on Antibiotics.
Depression and the ICU environment is a good combination to catch an infection. The doctors and the nurses might get tired to answer all the questions of the family, because there is just very little or no progress, or even setbacks and the Family doesn’t really want to know whether the PEEP and the Pressure support have been reduced. They want to see real and tangible results and not clinical results. Weaning is something that can be successfully done at home as well, with the right level of support and more importantly with the right mindset.
So what is the solution to the dilemma? Besides the depression, the lack of Quality of Life, the lack of privacy and the lack of dignity for the long-term ventilated adults& children with Tracheostomy in Intensive Care, there is also the depression and the desperation for Families of those Patients who, more often than not, are putting their lives on hold, whilst spending long periods of time in Intensive Care. Whilst their loved one is in ICU they are also neglecting other Family members and their personal and professional lives. Maybe they even take unpaid leave during the long term stay of their loved one in Intensive Care.
One of the biggest joys in life for a healthy person is having choice. Do we as Intensive Care professionals notice?
Is anybody listening to what Patients and their Families want if given a choice? Or do we just ignore what can be improved? When do we want to start treating health consumers as customers and create win-win situations? When do we want to make our customers king? (Hint, it’s not by giving antidepressants)
I’d like your views on this topic. How do you think depression in Intensive Care for long-term ventilated Adults& Children with Tracheostomy can be avoided in the first place? How can we make our Customers king? Leave your comments in the comments section below.
If you are a health professional in Intensive Care and you think you know a long-term ventilated Adult or Child with Tracheostomy and their Family who would like to improve their Quality of Life and/or their Quality of end of Life in their own home rather than in Intensive Care- even if it is to go home for a weekend- and if your organisation would also like to save money and resources along the way or if you simply have any questions, give us a call on 03-9939 7456 or simply send me an email to [email protected]