Intensive Care Society State of the Art (SOA) 2022 Abstracts

Abstract

Submission content Introduction: This is a story about the day I wheeled a patient outside. I know, it sounds somewhat underwhelming. But little did I know that this short trip down a hospital corridor and beyond the entrance foyer would mark a profound shift in perspective both for me and my patient, which I hope will influence me for the rest of my career. Main Body: "Paul" was in his 50s and severely afflicted by COVID-19, resulting in a protracted ICU admission with a slow and arduous ventilator wean. Throughout his time on the unit, Paul had seen no daylight;no view of the outside world. He was struggling to make progress and was becoming exasperated. His deteriorating mood in turn affected his sleep, which further undermined his progress. Due to COVID-19, visiting was not permitted and Paul's cuffed tracheostomy meant that he couldn't speak to his family. One day, witnessing Paul's psychological decline, I asked him if he fancied a trip outside. Despite initial reluctance, he eventually gave in to some gentle persuasion from the staff nurse, with whom he had developed a close bond. So there we went;Paul, his nurse and me. And as we wheeled his bed through the door into open air, Paul's whole demeanour suddenly changed. He appeared as though the weight of the world had been lifted from his shoulders and his face lit up with awe, a tear emerging in the corner of his eye. In that moment he rediscovered life. Not as a hospital patient, but as a person. Watching the world go by, he remembered what it was like to be a member of the human race, not the subject of endless tests and treatments. He tasted freedom. Conclusion(s): Awakened by his experience of the forgotten outside world, when we eventually returned to the ICU Paul was an entirely different man. To Paul, the trip outside symbolised progress. After weeks of frustration and despair, he finally had a purpose;a motivation to get better. Meanwhile, I was having my own quiet realisation. I now understood what it truly meant to deliver holistic care. It can become all too easy to focus on the clinical aspects;to obsess about the numbers. But in fact, often what matter most to patients are the 'little things', to which no amount of medication is the solution. I now try to consider during my daily review: what matters to this patient? How are they feeling? What are they thinking? What else can I do to help their psychological recovery? And as for me personally? Having witnessed Paul's reaction to the outside world, I suddenly became aware of how little attention I normally pay to the world around me. How little I appreciate the simple ability to walk outside, and the fundamental things we take for granted. Now, when I'm feeling annoyed or frustrated about something trivial, I stop and think of Paul. I then thank my lucky stars for what I have to be grateful for. Ultrasound Ninja.