Intensive Care Unit

14. Intensive Care Unit

The intensive care unit is designed differently from other areas of the hospital. It is a large room, sometimes with curtains between beds, sometimes not. Men, women, and children are all together. There is a central nurses station from which all patients are visible. Specially-trained teams of doctors and nurses are on duty twenty-four hours a day.

The ICU is a room which is definitely not conducive to health. The room is deliberately kept cool to decrease the body’s need for oxygen. This creates an additional stress to maintain proper body temperature.

When you first enter the ICU, it looks like something from a spaceship: wires, tubes, lights, pumps are hooked into and onto mostly immobile, white-sheeted figures. There are constantly flashing lights and beeps from monitors. It is eery and enervating. The light is eerily, intensely bright; there is constant, purposeful movement on the pan of the staff. There is rarely an outside window so there is no fresh air and little sense of time of day or season. Beneath all the apparatus it can be hard to recognize (and sometimes even see) the person you know.

14.1 Equipment

People in the ICU are often hooked up to cardiac monitor’s that provide records of the heart’s activity.

The screens that display these are usually placed at the patient’s bedside, as well as at the central nurses station. Tubes or masks often connect them to a respirator or ventilator. If it is believed that you will need help breathing over a long period of time, a tracheotomy (an opening into the trachea through the neck) may be performed. Moistened air or oxygen will be delivered to the area of the tracheotomy
through a plastic tube. Since the normal moistening mechanism (your nose and throat) is no longer doing this job, the air must be artificially moistened to prevent the drying of your respiratory passages.

Sometimes, to see how your heart is handling the blood it is receiving, a central venous pressure catheter is used. This is a thin tube inserted into a vein in your arm and threaded up to the large vein (vena cava) entering your heart.

To get a constant and precise measurement of your blood pressure, thin catheters called arterial lines may be in place in arteries in your arm. This makes it possible to check your blood pressure without having to put on the cuff and pump it up the way your doctor or nurse normally would. In other words, the pain and inconvenience experienced by the sick individual with these catheters if for the primary purpose of making the job of the nurse easier.

Often a Foley catheter, to drain urine, is in place in your bladder. It may flow into a bag and be measured from time to time—another unnecessary monitor.

14.2 People’s Reactions

Some people simply cannot tolerate being so totally dependent on other people and on machines. Others can’t bear the lack of privacy. Some feel that they’ll go mad from the noise, the continous bright light, the constant attention: temperature, pulse, respiration, and blood pressure are taken every fifteen to twenty minutes. You are burned, checked, made to sit up and cough and take deep breaths.

The people look terrible—pasty-colored, immobile, sometimes unable to talk and, worst of all, often disoriented. Disorientation is common in the ICU because of the constant noise, the lights, the lack of sleep, the fact that patients are seriously ill, may have a fever, and may be sedated so that they won’t fight the equipment. People often hallucinate and pass in and out of periods of clarity.

The environment in the intensive care unit is the opposite of what a proper environment for healing should be. These places should be called intensive abuse units. The proper environment should be quiet and peaceful. There should be plenty of windows so that the room is light and airy with plenty of fresh air from outdoors. Since sleep is the prime requirement for all sick individuals, they should never be disturbed when sleeping or resting. There is no equipment or chemicals that can heal—only the body can do that and rest is the primary need.