Critical care nursing quarterly
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Creating an environment of compassion where patients feel that their emotional and spiritual needs are met is at the heart of holistic care. Patient satisfaction surveys address this powerful aspect of care and nurses find themselves in the position of making an impact. The nurse is at the bedside when crisis occurs, both physical and spiritual. ⋯ Conscious or unconscious, the patient needs human touch and consolation, which transcends technology. Indifference to this is all but negligence on the part of the nurse. Addressing this through careful care planning and joining the "fellowship of pain" brings the nurse into the healing process. "Burnout" decreases as care increases, and nurses experience the healing process themselves as well.
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Delirium has been recognized in the literature as a significant problem in the care and treatment of the critical care patient. Delirium, a medical disorder that results in the morbidity and mortality of the patients, especially in the elderly, is often misdiagnosed and inappropriately treated. Nurses and other health care professionals need in-depth education about delirium, validated and understandable assessment tools, and astute clinical observational skills. A comprehensive and aggressive clinical management plan that incorporates appropriate pharmacological agents will result in less morbidity and improved long-term outcomes.
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Delirium in the intensive care unit (ICU) is a complex, common, and problematic condition that interferes with healing and recovery. It leads to higher morbidity and mortality and extended hospital stays. ⋯ Delirium is often unrecognized and misdiagnosed, which leads to mistreatment or lack of appropriate treatment. This article discusses the definition of delirium, pathogenesis, clinical practice guidelines, newer assessment tools for ICU, and nursing interventions directed toward prevention and early identification of delirium.
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Sleep deprivation is a significant problem for patients in critical care units. Sleep is a complex, active process that is divided into 4 stages of non-rapid eye movement (NREM) sleep, and rapid eye movement (REM) sleep. Noise, lights, discomfort, pain, medications, and stress all contribute to a patient's inability to sleep. ⋯ Education about sleep deprivation needs to be integrated into critical care courses and orientation programs. Sleep deprivation should be addressed on the multidisciplinary care plan and in health team conference, and nursing care planned accordingly. Sleep medications and their effects should be evaluated for each patient, as well as identifying medications that might be preventing or disturbing sleep.