27 November 2012
Stressors of the ICU
Trauma centers are places of high stress. The intensive care unit within the trauma centers is also a place of high physical and emotional stress. Staff, doctors, patients and families are affected by the mental trauma that is associated with the intensive care unit. Stating that the ICU causes “high stress” does not adequately describe the actual stress involved.
Even though the intensive care unit helps the physical needs of patients, it puts mental stress on the nurses, families, and patients (Cornock).
The healing of the patients is important, but the ways of coping after being in the ICU is also an important aspect.
Nurses deal with countless stressors of working in the intensive care unit at all hours of the night and day. Stress could be associated directly with the patient. Stress can also be shared by the doctors and families (Truog).
Not giving the family routine updates may cause stress, which can make them become hostile to the nurses and doctors (Truog).
This can create a negative effect on everyone in the ICU, especially the healing patient. Working in the intensive care unit, nurses experience extreme high physical and mental stress every day. Patient mortality is also a huge stress that each nurse deals with (Cornock).
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Nurses do not want to make mistakes in a stressful, pressure-filled environment.
Dealing with the patient and family’s stress is not an easy task. Even in the middle of a pressured-filled day, nurses remain calm. Each nurse puts on a calm attitude with the patient, family, staff, and doctors. When family and friends are stressed out because of their loved one, nurses and staff come in and calm the patient down (Truog).
Their sleep is interrupted, which causes more wear and tear on their bodies.
Nurses work many demanding hours and are constantly on their feet. They work all hours of the night and may even be called in from home if needed (Cornock).
This type of work promotes high physical and mental stress on their body (Cornock).
One demanding task is physical lifting and moving from site to site. Their job is to give aid to everyone they are assigned to. This can cause exhaustion during their shift, then manifest into negativity to the patient and family, which causes more stress overall (Scales).
Nurse labor laws were passed to restrict how many hours a nurse can work each shift (Scales).
This was passed so the stress on the body does not overwhelm them. Nurses already deal with countless hours of stress on their body in an eight hour period. With time bumped up to twelve hour nights for a nurse, their career may turn into what may soon look like a unfulfilling job (Truog).
Nurses and staff have huge responsibilities, and are responsible for caring for the patients’ well-being. The nurse is also responsible for any mistake he or she might make when giving treatment (Scales).
This can put even more stress on the nurse because they are responsible for every decision they make. If a critical wrong decision is made, a nurse may face termination (Scales).
Aside from the physical aspects of working in the intensive care unit, there are numerous factors nurses deal with daily that are physiological (Cornock).
For example, many nurses during their career, especially those working in the elderly care centers, deal with hospice centers. Working in hospice can be a very hard center to work in day-by-day. They also need to confront and comfort the loved one’s family in their time of need. Confronting a family of their loved one’s death can be hard and mentally hard for a nurse to go through. This job is for the emotionally strong people. The nurse also cannot get emotionally or physically attached to their patient (Scales).
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Some ICU nurses stress about developing post-stress disorder 3">traumatic stress disorder (PTSD).
Intensive care unit nurses, who are repeatedly exposed to trauma and stress, are at increased risk levels to develop this and have the inability to adjust to this stressful environment.
Some intensive care perspectives, when comparing patients and nurses, are also very comparable. Some worries of being in the intensive care unit differ from person to person and the stress levels from each person changes constantly (Pang).
There is also additional stress on the nurses and staff because there are continuous potential hazards and sicknesses they may catch in this hazardous environment (Cornock).
For example, nurses need to be cautious so they are not infected with blood borne pathogens they are in contact with on a daily basis (Pang).
Stress about catching diseases and sickness is just a small factor of what nurses and staff stress about when looking at the big picture of caring for their patients.
When the family is entering a stressful intensive care unit area, “stress” may be a word much too calm for this high intensity environment. Having a family member hospitalized in an intensive care unit can be an emotionally, physically, and demanding experience (Scales).
Family and friends have ongoing stress because of worry their family is experiencing anything negative during their stay. Another factor of stress in the intensive care unit is the cost of the loved one’s stay and the financial responsibilities that go along with it (Pang).
Another potential stressor is how long their loved one will have to stay in the ICU and how long their sickness or healing process may last. The family and friends of the patient might get very tired and sleep deprived from staying at the hospital for so many long hours, around-the-clock in many cases. Families may even become hostile towards the nurses and even doctors (Pang).
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Being unable to get vital information about their family member and how they are doing is another problem. Families may be unaware of the rules and regulations of the hospital and the ICU. Families want to be accepted by the intensive care unit staff and not be thought of as an intruder.
One of the biggest and major factors of working in an ICU is dealing with the loss of a loved one. This is an overwhelming factor in the ICU especially with the family. The family may be in a state of emotional shock and may not be able to think clearly.
Eating habits of the family may also change caused by stress in the intensive care unit (Cornock).
They may eat less due to overwhelming mental stress. This lack of nutrition may hinder their ability to think clearly and they may make poor decisions.
Another big factor in the intensive care unit is that family roles may change in the family when given high stress. Family members may step up to the plate and take control of the situation while other family members may step back from the stress and have others take care of it (Scales).
They may also take an optimistic approach and keep a positive attitude to deal with so much stress (Truog).
One of the most stressed people involved in the intensive care unit is the patient. The patient may be overwhelmed by a strange environment (Truog).
For example, lights, strange noises, and a new room, may account for a small amount of what a patient overcomes day-by-day (Scales).
Patients have countless stressors, more stressors than the family and nurses put together. Fear of death, being in pain, not being able to communicate, and unfamiliar and unusual noises are just a few of the stressors of a patient (Cornock).
Another stress for the patients is that they may not have any family and have to take care of themselves and have no one to support them in anyway. These issues may all be the cause of stress.
A disorder a patient and family may suffer with is PTSD. The stress on the patient, the length of the stay, and what occurred to the patient during the stay may account for post-traumatic stress disorder in the long run (“ICU Nurses Face A Higher Risk Of PTSD”).
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Delirium and hallucinations also are associated to post- traumatic stress (Holzmueller).
Not only the patients, but the family and staff as well, can use these strategies to help them recover. Delirium is when there is sudden severe confusion which accounts for a mental illness (Holzmueller).
Delirium is also when there are rapid changes in how the brain is functioning (Holzmueller).
Hallucinations are when patients may see or imagine things in their head and see them while they are awake. Hallucinations are also considered a mental illness for stress from the intensive care unit and should be treated (“ICU Nurses Face A Higher Risk Of PTSD”).
Many patients may get a therapist for these types of behaviors. Acupuncture is another way to cope with PSTD. Just like the patient, family can also exercise, meditate, go to therapy, or use diversion to get through the effects of post-traumatic stress disorder (Pang).
These behaviors can cripple a person, family, or home after the healing process of the intensive care unit (Pang).
When there are behaviors that can damage a person so vitally, critical actions need to be put into action immediately (Cornock).
This is so the condition does not get any worse. This also protects the patient, family members, and friends so they know what’s going on with their loved one and they can deal with each issue better.
Another disorder that patients may suffer with after leaving the intensive care unit are night terrors (Kynoch).
Night terrors are comparable to nightmares, but are much more dramatic causing disturbances in the sleep pattern of a healing patient (Kynoch).
Night terrors can sometimes be treated with high dose medication, therapy, and treatments (Kynoch).
Anxiety and depression may be another factor after leaving the intensive care unit depending on how much stress was put on the patient during the stay (Pang).
These disorders may be treated with a wide variety of coping strategies, and sometimes medication. Some of these strategies include exercise, diversion, meditation, yoga, aromatherapy, massage, and even sleeping to reboot the brain (Cornock).
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These are just a few ways for them to cope.
Nurses, family, and patients all may need mental therapy after dealing with the tragic events that occur in an intensive care unit. Patients may go to therapy to deal with traumatic stress from being in the unit. Patients and family may go to support groups to deal with the stress of being in the ICU also. Families may partake in the Support and Family Education Program (SAFE) to deal with post-traumatic stress disorder (Kynoch).
Some patients may deal with stress in other ways like starting journals reflecting on their experience and working through the trauma that occurred to them (Kynoch).
Being a patient in the intensive care unit can be life changing. Some patients may have had a near death experience. This may result in a change in behavior, religion, attitude, or day-by-day habits and activities (Kynoch).
This accounts for the family as well. If a family member watched a loved one die, this may result is a tremendous change in lifestyle (Scales).
The actions, day-by-day living, and habits may all be affected over time by post-traumatic stress disorder or other stress disorders that occur after a tragic event (Kynoch).
Everyone that has been involved in the intensive care unit needs to keep a positive outlook on the future and not remember the past of being in the ICU.
Being a patient, family member, and part of the staff are extremely important roles in the intensive care unit. Although the ICU may be a stressful process to deal with, it is necessary for recovery (Pang).
Instead of looking at this as a negative experience, remember that the nurses and staff are there to help, not hurt. Although it may be intimidating at first glance if patients, family, and staff put aside the stressors of the ICU, it simply becomes a treatment and healing center. Even though the intensive care unit may serve as a tough place to heal in, there is help and ways to get through this emotionally stressful environment and ways to cope.
Works Cited
Cornock, Marc A. “Stress And The Intensive Care Patient: Perceptions Of Patients And Nurses.” Journal Of Advanced Nursing 27.3 (1998): 518-527. Health Source: Nursing/Academic Edition. Web. 24 Sept. 2012.
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Kynoch, Kate, Jody Paxton, and Anne M. Chang. “ICU Nurses’ Experiences And Perspectives of Caring For Obstetric Patients In Intensive Care: A Qualitative Study.” Journal Of Clinical Nursing 20.11/12 (2011): 1768-1775. Health Source: Nursing/Academic Edition. Web. 24 Sept. 2012.
Pang, Pounds Siu Kau, and Lorna Kawi Ping Suen. “Stressors In The ICU: A comparison Of Patients’ And Nurses’ Perceptions.” Journal Of Clinical Nursing 17.20 (2008): 2681-2689. Health Source: Nursing/Academic Edition. Web. 24 Sept. 2012.
“ICU Nurses Face A Higher Risk Of PTSD.” Nursing 37.4 (2007): 64cc4. MasterFILE Premier. Web. 24 Sept. 2012.
Holzmueller, Christine G. “Intensive Care Unit(ICU).” Magill’s Medical Guide, sixth Edition. Ed. Tracy Irons-Georges, 6th ed. 6 vols. Pasadena, Calif.: Salem Press, 2010. Salem Health Web. 07 Sep. 2012
Scales, Damon C., and others. “Illness in the Intensive Care Staff After Breif Exposre to Severe…”Emerging Infections Diseases. Oct. 2003 :1205-1210. SIRS Government Reporter. Web. 07 Sep 2012.
Truog, Robert D. “Triage in the ICU. “Haistings Center Report. May/June 1992: 13-17. SIRS Issues Researcher. Web. 08 Sep 2012.
