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Being in limbo: The experience of critical illness in intensive care and beyond

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DOI: 10.4236/ojn.2012.23041    5,483 Downloads   9,099 Views   Citations

ABSTRACT

Critical illness is a sudden traumatising lived experience that affects the sufferer and their family throwing them into a crisis situation [1,2]. It is disruptive and alienating. Critically ill patients emerging from unconsciousness often suffer from confusion that could be momentary or lasting. There is an increasing number of critical illness survivors in intensive care units (ICU)1 with numerous life changing ongoing physiological and psychological sequelae from critical illness and ICU hospitalization, with inadequate ongoing treatment for ICU survivors. Medicalised accounts of critical illness fail to recognise the significant impact on the person, their embodied sense of self and their ability to move on with their life after they leave hospital. The main purpose of this study was to explore the experience of critically ill patients in ICU and beyond. This phenomenological study describes what it was like for twelve people to experience critical illness in ICU and in the months after discharge. The finding was that critical illness is an acute life threatening event with long lasting effects which translate into temporal and biographical disruption, imprisonment by the ICU and its therapies and being trapped in an alien body that is plagued by uncertainty and long lasting conditions arising from the critical illness and the ICU therapies. Critical illness survivors are left in a state of limbo characterised by a struggle to reclaim their precritical illness ICU identity and uncertainty about their future. Hence an overarching theme of being in limbo under which three major themes of 1) disrupttion, 2) imprisonment and 3) being trapped were generated from the study.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Tembo, A. , Parker, V. and Higgins, I. (2012) Being in limbo: The experience of critical illness in intensive care and beyond. Open Journal of Nursing, 2, 270-276. doi: 10.4236/ojn.2012.23041.

References

[1] Kinrade, T., Jackson, A.C. and Tomnay, J.E. (2009) The psychosocial needs of families during critical illness: Comparison of nurses’ and family members’ perspectives. Australian Journal of Advanced Nursing, 27, 82-88.
[2] Urden, L.D., Stacy, K.M. and Lough, M.E. (2006) Thelan’s critical care nursing diagnosis and management. 5th Edition, Mosby, Missouri.
[3] Parker, V. (1997) Confronting life and death: Living through critical illness and intensive care hospitalisation. The University of Newcastle, Newcastle.
[4] Caroll, S.M. (2007) Silent, slow lifeworld: The communication experience of nonvocal ventilated patients. Qualitative Health Research, 17, 1165-1177. doi:10.1177/1049732307307334
[5] Wang, K.F., Zhang, B., Li, C.Y. and Wang, C. (2008) Qualitative analysis of patients’ intensive care experience during mechanical ventilation. Journal of Clinical Nursing, 18, 183-190. doi:10.1111/j.1365-2702.2008.02518.x
[6] Adamson, H., Murgo, M., Boyle, M., Kerr, S., Crawford, M. and Elliott, D. (2004) Memories of intensive care and experiences of survivors of a critical illness: An interview study. Intensive and Critical Care Nursing, 20, 257-263.
[7] Coyer, M.F., Wheeler, K.M., Wetzig, M.S. and Couchman, A.B. (2007) Nursing care of the mechanically ventilated patient: What does the evidence say? The Journal of Intensive and Critical Care Nursing, 23, 71-80. doi:10.1016/j.iccn.2006.08.004
[8] Kress, J.P., Pohlman, A.S., O’Connor, M.F. and Hall, J.B. (2000) Daily interruption of sedative infusions in critically ill patients undergoing mechanical ventilation. New England Journal of Medicine, 342, 1471-1477. doi:10.1056/NEJM200005183422002
[9] Wunsch, H. and Kress, J.P. (2009) A new era for sedation in ICU patients. Journal of the American Medical Association, 301, 542-544. doi:10.1001/jama.2009.24
[10] Kress, J.P. and Hall, J.B. (2006) Sedation in the mechaniccally ventilated patient. Journal of Critical Care Medicine, 34, 2541-2546. doi:10.1097/01.CCM.0000239117.39890.E3
[11] Hall, J.B. (2010). Creating the animated intensive care unit. Critical Care Medicine, 38, S668-S675. doi:10.1097/CCM.0b013e3181f203aa
[12] Kress, J.P., Gehlbach, M.L., Pliskin, N., Pohlman, A.S. and Hall, J.B. (2003) The long-term psychological effects of daily sedative interruption on critically ill patients. American Journal of Respiratory and Critical Care Medicine, 168, 1457-1461. doi:10.1164/rccm.200303-455OC
[13] Drennan, K., Hicks, P. and Hart, G.K. (2008) Intensive care resource and activity: Australia and New Zealand 2009/2010. Centre for Outcome and Resource Evaluation (CORE). http://www.anzics.com.au/core/reportsaccessed25/11/201
[14] Elliott, D., McKinley, S., Alison, J., King, M., Aitken, L.M., et al., (2011) Health-related quality of life and physical recovery after a critical illness: A multi-centre randomised controlled trial of a home-based physical rehabilitation program. Critical Care, 15, R143. doi:10.1186/cc10265 http://ccforum.com/content/15/3/R142Accessed17/10/2011
[15] Khan, J.M., Benson, N.M., Appleby, D., Carson, S.S. and Iwashyna, T.J. (2010) Long-term acute care hospital utilisation after critical illness. Journal of the American Medical Association, 303, 2253-2259. doi:10.1001/jama.2010.761
[16] Wiencek, C. and Winkelman, C. (2010) Chronic critical illness: Prevalence, profile and pathophysiology. Advanced Critical Care Nursing, 21, 44-61.
[17] Desai, S.V., Law, T.J. and Needham, D.M. (2011) Long-term complications of critical care. Critical Care Medicine, 39, 371-379. doi:10.1097/CCM.0b013e3181fd66e5
[18] Needham, M.D., Feldman, D.R. and Kho, M. (2011) The functional costs of ICU survivorship: Collaborating to improve post-ICU disability. American Journal of Respiratory and Critical Care Medicine, 183, 962-964.
[19] Elliott, D., Mudaliar, Y. and Kim, C. (2004) Examining discharge outcomes and health status of critically ill patients: Some practical considerations. Intensive and Critical Care Nursing, 20, 366-377. doi:10.1016/j.iccn.2004.07.001
[20] Ringdal, M., Plos, K., ?rtenwall, P. and Bergbom, I. (2010) Memories and health related quality of life after intensive care: A follow-up study. Critical Care Medicine, 38, 38-44. doi:10.1097/CCM.0b013e3181b42909
[21] van Manen, M. (1990) Researching lived experience: Human science for an action sensitive pedagogy. State University of New York Press, Albany.
[22] Merleau-Ponty, M. (1962) Phenomenology of perception. Routledge & Kegan Paul Ltd., London and New York.
[23] Almerud, S., Alapack, R.J., Fridlund, B. and Ekebergh, M. (2007) Of vigilance and invisibility—Being apatient in technological intense environments. Nursing in Critical Care, 13, 151-158. doi:10.1111/j.1478-5153.2007.00216.x
[24] Zeilani, R. and Seymour, J.E. (2010) Muslim women’s experiences of suffering in Jordanian intensive care units: A narrative study. Intensive and Critical Care Nursing, 26, 175-184. doi:10.1016/j.iccn.2010.02.002
[25] L?f, L., Berggren, L. and Ahlstrom, G. (2008) ICU patients’ recall of emotional reactions in the trajectory from falling critically ill to hospital discharge: Follow-ups after 3 and 6 months. Intensive and Critical Care Nursing, 24, 108-121. doi:10.1016/j.iccn.2007.08.001
[26] Samuelson, K.A.M. (2011) Unpleasant and pleasant memories of the intensive care in adult mechanically ventilated patients—Findings from 250 interviews. Intensive and Critical Care Nursing, 27, 76-84. doi:10.1016/j.iccn.2011.01.003
[27] Almerud-?sterberg, S. (2010) Visualism and technification—The patient behind the screen. International Journal of Qualitative Studies on Health and Well-Being, 5, 5223.
[28] Happ, M.B., Harrington, C. and Kluger, M. (2006) Nonspeaking older adults in the ICU. American Journal of Nursing, 106, 30.
[29] Capuzzo, M., Bertaccchini, S., Davanzo, E., Glovanna, F., Paparella, L. and Tadini, L. (2010) Health-related quality of life before planned admission to intensive care: Memory over three and six months. Health and Quality of Life Outcomes, 8, 103. doi:10.1186/1477-7525-8-103
[30] Weinert, C. and Sprinkle, M. (2008) Post ICU conesquences of patient wakefulness and sedative exposure during mechanical ventilation. Journal of Intensive Care Medicine, 34, 82-90. doi:10.1007/s00134-007-0829-2
[31] Beraldo, P.S.S. (2009) Rehabilitation in patients admitted to intensive care. British Medical Journal, 339, 982-983. doi:10.1136/bmj.b3921
[32] Happ, M.B., Garrett, K., DiVirgilio, D., Thomas, M., Tate, J., George, E., et al. (2011) Nurse-patient communication interactions in the intensive care unit. American Journal of Critical Care, 20, e28-e40. http://www.ajcconline.org,Accessedon12/04/2011
[33] Tembo A. C and V, P. (2009) Factors that impact on sleep in intensive care patients. Intensive and Critical Care Nursing, 25, 314-322. doi:10.1016/j.iccn.2009.07.002
[34] Cuthbertson, B.H., Rattray, J., Campbell, M.K., Gager, M., Roughton, S., Smith, A., et al. (2009) The practical study of nurse led, intensive care follow-up for improving long term outcomes from critical illness: A pragmatic randomised controlled trial. British Medical Journal, 339, b3723. doi:10.1136/bmj.b3723

  
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