The Ventilated Patient's Experience

Abstract

Background: Critically ill intensive care unit (ICU) patients often experience pain, anxiety, panic, fear, dyspnea, and distress related to mechanical ventilation. Patients' recollections vary from having little or no memory of actual events to having total recall. Few studies have examined family members' memories and congruence with patients' symptom report and nurse observation.

Objectives: To describe the experience of the mechanically ventilated ICU patient.

Aims: (1) to explore patient and family memories of pain, anxiety, distress, and dyspnea following mechanical ventilation; (2) to determine if there is a correlation among nurse-documented pain assessment and patient- and family-reported pain intensity; and (3) to determine the level of patient and family satisfaction with care while on the ventilator.

Methods: This was a descriptive study design. A convenience sample of ICU patients (n = 84) and family members (n = 77) was interviewed. Medical record data abstraction included patient demographics, medication administration, and nurse assessment of pain and sedation.

Results: Most patient and family members reported memories of pain, anxiety/panic, nightmares or distress, and trouble breathing. Patients' perception of anxiety, nightmares, and dyspnea were moderately correlated with their pain perception (P = .000). Family members' memories of pain were correlated with nurse pain assessment behavioral scale ratings, but patients' memories of pain were not. Patients and family reported high satisfaction scores.

Conclusion: Further inquiry of the patient's experience with mechanical ventilation, the use of a ventilation sedation management protocol, and the evaluation of effective communication tools such as the use of bedside reporting or patient communication boards is warranted.