Think about this: Imagine living in a small space, surrounded by the same four white walls for a long period of time (that is days to weeks). Locked away from your normal day to day life, only witnessing the sunshine through the window. Laying in the same bed, at times moving around with help, only leaving to walk around for a few short minutes at a time. Connected to multiple wires and tubes, some on the arms, some on the hands and fingers, some to the neck, and maybe some attached to the head as well. An invasive respiratory tool is at your nose and sometimes involving the mouth, irritating you, yet is the one thing helping you breathe. Another tube down your nose, supposedly feeding you, yet you have not enjoyed the luxury of tasting food in a few days. While sitting there, almost motionless in bed, for a few days, losing track of the time and days, strangers peeking through the hall every few minutes, multiple new faces coming in to talk to you about the most valuable thing in your life: your health…
How would you feel?
While battling life and death, what was just described is a sample of the day to day life of a patient in the ICU. Although many are sedated and intubated, unaware of their surroundings, there are patients who are awake and aware. While waiting for possibly life changing results, alert patients in the ICU often feel the isolation of being alone and vulnerable. The thought becomes, how can we help patients feel comfortable? How can we help heal our patients, not just simply treat their ailments?
My time on geriatrics has taught me a very valuable lesson: Getting to know the patient by asking, “What matters most to you?” A question about how to make the patient more comfortable, which is not necessarily a part of our daily morning checklist. Getting to know what is fueling their agitation or frustration, listening to their concerns, and making them feel heard are important aspects of every physician-patient relationship.
Reflecting on my first patient admit on the ICU service–a young patient with a worsening chronic illness, high oxygen needs, and slowly declining lungs–all he wanted when I inquired if he had any questions every morning was,“I want to go home.” Knowing his critical condition and the difficulty of getting him home soon, I knew it was hard to get him home, and harder to say it to him every morning. One day, I inquired, “What matters most to you?” and “What can we do here to make you feel at home?” To my surprise, all he wanted was to see the outside and celebrate his mother’s birthday in the coming days. Working with the rest of the team, taking the patient out to the healing garden, spending time with him outside in the sunshine, and letting him see the outdoors for the first time in a long time was something he appreciated and thanked the team heavily for. Similarly, making accommodations and helping him set up to celebrate his mother’s birthday in his ICU room was another form of healing that this patient needed. It was the first time throughout his hospitalization that I saw him smile, and surely one of the few times I felt I had actually helped him feel better.
This experience has allowed me to reflect on the patient perspective of being in the ICU and partly understand the challenges they face during such a hard time. The Intensive Care Unit remains one of the more intense services for us as students, residents, and physicians. At the same time, it is generally the most intense life event for a patient. This patient experience will surely stay with me as I progress in medical training to remind me to ask my future patients, “What matters most to you?” and to think about the patient’s experience beyond their disease. It also allows me to recognize the importance of teamwork between nurses, physicians, and respiratory techs in working on making patients comfortable. Next time you are on the ICU service, ask yourself: How does that patient feel? And, what can we do about it? The answer might be as simple as taking them out to see the sun in the healing garden.
Ghena Krdi
Ghena Krdi is a member of the University of Arizona College of Medicine – Phoenix, Class of 2025. She graduated from Arizona State University with degrees in Biological Sciences and Communication, and the University of Arizona with a Master’s in Medical Studies. She is passionate about health equity, improving patient care, increasing diversity in medicine and mentorship. In her free time, she loves hanging out with family and friends, exploring coffee shops, working on art projects and practicing fitness yoga.