Psychiatric Problems in Patients Who Survive Critical Illnesses (Part 2)

By Joseph O. Bienvenu, MD, PhD and Dale M. Needham, MD, PhD | December 20, 2012

The psychiatric aftermath of critical illness often involves emerging from the ICU with horrifying memories (of being tortured, raped, assaulted, or imprisoned). Not only are the patients debilitated by the physical illness, they are traumatized by the false memories resulting from delirium.

In Part 2 of this 2-part video, Dr Joe Bienvenu, Associate Professor of Psychiatry, and Dr Dale Needham, Associate Professor of Pulmonary Critical Care Medicine and Physical Medicine Rehabilition, discuss the effects of critical illness and the need for collaborative interventions in the ICU that will improve long-term patient outcomes. (For Part 1, please click here),

by Ann Sparks, RN, APN, FNP-BC | December 22, 2012 11:09 AM EST

Thank you Drs Joe Bienvenu and Dale Needham for this brief explanation of the "PTSD-type"phenomenon resulting from critical care patient experiences.

To provide a little background, I am a nurse with 25+ years of experience; a decade or so in critical care and also nearly a decade in psych and addictions nursing. I have also recently obtained my MSNursing as a Family Nurse Practitioner.

I would be interested in working with you on this phenomena of emotional trauma during critical care. When I worked in the ICU, I was very in tune to patient's emotional needs and the often times "tragic emotional situations" that were present on a daily basis. Really, what patients go through with feelings of torture, assault and imprisonment, in many ways, are not far from the truth... in terms of what really does happen.

Let me give you an example. Just this weekend, I have an acquaintance who is going for a cardiac cath. As soon as I realized this, I went to talk to him. As he was very alert, with minimal anxiety, I explained to him that IF he goes on for a CABG (open heart surgery), he will wake up on a ventilator (a tube down his throat, feeling like choking) with his hands tied down (most often the standard for intubated patients). I coached him how to deal with these events and the feelings of "torture, assault and imprisonment" that he may experience.

I can give you numerous examples of patients, often being treated like "slabs of meat" in the ICU... while staff take care of the physical needs as best they can. I had a patient who was on a stryker frame after an MVA. He'd been in the hospital for about 5 days. I came in, assessed him, turned him, and gave him his meal tray. I bent down to meet eye to eye with him and asked him if he was okay... if he needed anything. His response was so telling and it touched my soul. He said, "No, thank you. Ya know, you are the first person who has treated me like a human being since I've been here." I really did feel so sad about our "system" and healthcare in general.

When we continue to compartmentalize psychiatric and sociological needs apart from physical needs, we are asking for tragic consequences.... ranging from PTSD to obesity and addictions. The specialties of Psychiatry, Psychology and Sociology need to be fully integrated into our healthcare, not just a specialty off to the side that many practitioners avoid dealing with.

Thank you for allowing me to participate. I look forward to being an increasing part of this discussion.

Ann Sparks, RN, MSN, NP - C

Psychiatric Problems in Patients Who Survive Critical Illnesses (Part 2)

Join the Conversation