Chapter 16: Care of the Highly Dependent and Critically Ill Adult
Ann is a 67-year-old woman, who was cared for within a general critical care unit for an extended period, after developing sepsis post-operatively. She was initially admitted electively to critical care for post-surgery care.
With a medical history of recently developing an acute exacerbation of Crohn’s disease, with developing severity of symptoms and was admitted to hospital for a total colectomy. She also has significant history of COPD and prone to chest infections. Therefore, the decision was taken for her to be admitted to critical care for the immediate post-operative period, to support her needs.
Ann remained ventilated following surgery, she then developed a severe left-sided pneumonia and unfortunately also suffered additional health setbacks, which required her to be supported and nursed within critical care for several weeks.
Following discharge to a general ward, although she remained weak, plans were already in place for her rehabilitation to continue upon discharge home, with support. The day before she was being discharged home, Ann developed confusion and expressed concerns and anxieties as she could not remember her prolonged critical care stay and could not understand why she was so weak. This was naturally very distressing for Ann, her family and the staff.
Ann’s family and the nursing and multi-disciplinary team, attempted to explain to Ann the care she had required within critical care, along with the challenges she had faced during her extended stay. Despite continued reassurances and discussions of events, Ann could not recall much of her last few weeks. This obviously resulted in considerable psychological and emotional distress, not only for Ann but also for her family. Ann’s holistic needs were addressed, and steps taken to support her and her family.
This scenario demonstrates the significance of ensuring person-centred care is provided compassionately, considering the needs of the patient, their family and of staff involved too. Effective communication and interpersonal skills are fundamental in ensuring the patient is cared for holistically.