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Detailed Needs and Requirements: Intensive Care Units
Many intensive care patients are in a critical life state when brought to
the unit; however, some patients may be admitted to receive this level
of care to prevent the development of critical conditions. Patients will
be kept on the unit until their conditions are stabilized such that they
may be safely cared for in a less intensive nursing environment. The
duration of stay, therefore, may vary from a matter of hours to weeks.
Some intensive care or cardiac care patients may be unconscious or
heavily sedated. Many patients however, will be conscious or semi-
conscious. These patients may be uncomfortable or in pain, confused,
and frightened or apprehensive about their condition. The activity in
the unit, the essentially strange environment, possibly compounded by
dependence on monitoring and life support equipment, the awareness
of other critically ill patients, and the loss of ability to care for
themselves may increase this fear or confusion. In some cases,
patients have developed moderate to severe neuroses during their
stay on intensive care of cardiac care units as result of such factors.
Steps may be taken to avoid these adverse psychological effects.
Patient exposure to potentially disturbing aspects of these units may
be minimized, e.g. they may be visually and acoustically isolated from
other critically ill patients and from activities such as emergency
treatment or removal of deceased patients. Unfamiliar life support and
physiological monitoring equipment required at the patient's bedside
may be located, when possible, out of the patient's normal field of
vision. The patient's awareness of his environment may be reinforced
by making his personal possessions visible and easily accessible and
by providing windows so that he can observe the time of day or night.
In addition to positive psychological effects, acoustic isolation of
individual patients in intensive and cardiac care units would provide
areas for confidential and often emotional conversations with
physicians, clergy, nursing staff, social workers, or visitors.
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