We could not finish this week of interviews without talking with the engine of the ICU. The angels without wings are the nurses, and they develop their day-to-day beside the bed.
For this purpose we have interviewed to Laura Díaz, nurse of Intensive Care Unit of the Hospital Universitario Doce de Octubre.
For me it´s essential to preserve privacy, and of course with the actual distribution, we cannot be performed in the most appropriate manner. But that is a good approach to the ICU of new creation. The reality is that in the old ICU, we must work and adapt ourselves to the enviroment we are, using for example curtains or screens which separate boxes. They are not very aesthetic but effective.
Again their privacy. And of course, to favour whenever possible, the family could stay with them. We should ensure a peaceful environment, respecting as far as possible the hours of sleep, down lights and voice at night and controlling what is said out loud. Sometimes we believe that when the patient is in the ICU bed, as well as the pathology for which is admitted , he/she becomes deaf and blind to everything we say and do.
Here there are many things to improve. Unfortunately the space is what it is, and there are many devices surrounding the ill patient, making difficult tfor the family for example could sit beside while you are with the patient. The patient usually requires many nurse interventions, so the family sometimes has the feeling of “clogging” and prefers to withdraw so that “you do our work better”. It is important that we make them feel part of the care.
On the other hand, to have a comfortable waiting room, with seats for the rest of the family, or tables where they can sit to eat, because many times they come from out of town and have no space to stay, as well as a bathroom with shower are elements that I can think could make more bearable for the family the moments of waiting.
In our design studio, we believe that it is very important to create a space in which the patient feel at home, as you said before, in a “family” space because it would affect the speedy recovery of the patient. We believe that it is feasible and it would not be a huge economic cost, elements such as decorative lamps may be used to add a cozy element, use touches of colors that convey energy and positivity, there are many possibilities. What is your opinion about an aesthetic change?
I think that the best way to create a close space is let each patient to bring something that makes him /her feel better. It is very common that family bring you photos, drawings of children or grandchildren that we stick to the wall so they can see it, books or even a TV. Each person are one world and I think that we could create a much more inviting space in this way.
As I’ve said before, it is necessary and essential. There are numerous studies about ICU delirium that deal with this topic, and not only that, but to promote a speedy recovery of the patient it is essential their rest and maintaining circadian rhythms. Respecting the hours of sleep without techniques and medications that are not absolutely essential, the light, lowering the tone of voice… All this is not easy, an ICU is usually open, with patients complex requiring many care and new admittances at any time of the day or night… But there are many things that we can and we must avoid simply being more careful in how we do things.
And lastly I would like to ask: do you have any suggestions?
Tell us about them!