In this post I would like to talk about several things that are giving turns in my head lately.
In first place, I have to tell that professionals solving consultations in remote it´s usual, only looking the clinical electronic report in their computer, and they say: “I have already answered your query”… without seeing to the patient!.
Secondly, the way in which we answer a question with a response that includes the projection of the problem to another professional. I mean, if someone ask us why a critically ill patient is not yet in disconnection, we sometimes answer: “Well, that is because the auxiliary team or the physiotherapist has not come or the order is not written… Excuses of professionals that do not have internalized teamwork.
Thirdly, we are used to bombard our patients with tests and more tests: CT, angio-CT, MRI, C-reactive protein of all, sophisticated laboratory test… and what about that well done clinical report which requires quietly talking to and touching the patient thorough a deep clinical examination? In addition, sometimes we manage our critical patients with treatments that are not supported in published scientific evidence: in recent times many negative scientific work have been published about treatments carried out over many years in the ICU.
And in fourth place, the current idea of humanizing the ICU. But hey, how was our treatment until now?. Therefore it should not be entirely correct since this concept has mobilized and mobilized a lot of people in the world. Anyway, and putting aside the appearance more than fashion and media of the #HumanICU, I think that we have come a long way in this regard and I am sure that in all ICU these measures of improvement have been applyed one way or another, in greater or lesser scale in the management of critically ill patients and their families.
To summarize my post today, I just think that our attention must be:
– With much “Touch”: speaking with the patient, exploring rightly, staying with him /her and explaining procedures we are going to do.
– Working in “Team” with all the professional involved in the care of the patient in equality of conditions (doctors, nurses, assistants, physiotherapists, psychologists, guards and personal assistants).
– Always with the “Tech”: using the systems of clinical information properly. The electronic systems of data collection offer security but also allow us to work without viewing the patient; the tests help to diagnose but without make it giving sticks of blind. And all this must be applied.
– With a careful “Treat” towards the patient and the family, which includes privacy, respect, proximity, expanded visits, more kind and comfortable rooms, noise control and letting night rest.
In short, humanizing intensive care.
Have a nice day and good luck!
Dr. Josep-Maria Sirvent
Intensive Care Unit
Hospital Universitari de Girona Doctor Josep Trueta