Having a permanent resident in intensive care: The rewards and challenges

Abstract

Background: Intensive care units are generally structured and staffed to care for short-term critically ill patients. This is in contrast to the increasing incidence of patients who require long-term (i.e. greater than 6 months) intensive care in the contemporary health care context. Aim: The aim of this paper is to share our experience of caring for a long-term ventilated patient in intensive care, including providing a summary of strategies and considerations that proved effective in our setting. Process: Dealing with the initial reactions of the staff, patient and family was the first focus of care, with strategies developed to manage the psychological as well as practical challenges. Core to subsequent strategies was the early formation of a multi-disciplinary case management team. Ongoing challenges included integrating rehabilitation care into the intensive care, developing effective multi-dimensional communication strategies, facilitating appropriate involvement of the patient and her family, operationalising trips outside the intensive care environment and adapting the model of nursing care to suit the context.