PTSD from the ICU
An interview with film-maker Nancy Andrews about her experience as a patient in the surgical ICU. Nancy describes the ICU as a torture chamber, where if you didn’t know they were saving your life, you’d think they were trying to kill you. She describes becoming delirious under the influence of painkillers and sedatives, and gives a vivid description of the hallucinations and fears that followed. Upon her release from the hospital Nancy noticed that she kept having “weird experiences”as if she was back there,” which her doctor fortunately recognized as flashbacks from PTSD. Nancy’s film, On a Phantom Limb, explores the horror and disorientation of being an ICU patient. She says that while she is “unable to bear watching scenes of surgery or the physical restraint of others, making a film about it was empowering because I was in full control of the film, in ways that I was out of control as a patient.” She is passionate about getting the message out that PTSD after the ICU is common, and that early identification and treatment can make a tremendous difference.
As a new ICU nurse just a couple of years ago, I asked my preceptor (the nurse training me during my orientation to the unit) what her thoughts were on whether or not our sedated and ventilated patients (those on life support) could remember their experiences in ICU. I asked this because I noticed that I seemed to be one of the few staff who would talk to and explain to my sedated patients what was going on around them. Although they appeared to be asleep or unconscious, I’d introduce myself when I came into their room and I’d let them know what I was doing; whether it was listening to their lungs and heart, administering medications into their IV’s or about to give them a painful injection. I knew they could hear me and I was certain that they had to be very afraid of all the sounds and things going on around them while they could not open their eyes. I was told by my preceptor that she was pretty sure our ventilated patients had no recollection of their time spent in the ICU.
Ms. Andrews’ film should be required viewing for ALL hospital staff caring for ICU patients; including the nurses, doctors, x-ray techs, dieticians, nursing assistants and even the janitors.
Yes, I complete agree with Nancy who describes ” the ICU as a torture chamber, where if you didn’t know they were saving your life, you’d think they were trying to kill you.” I was too in ICU and it was the most terrible experience. I was terrified. I could see the nurses with horrible faces. I was sure they had a plan to kill me. I had 35 different “chapters” of terror while in ICU. I remember perfectly well all these experiences. However, when doctors and nurses and family members spoken to me in high and kind way I could feel a great relieve. My family motivate me to write notes letter by letter to describe how i was feeling. It was when I began to let them know that I was terrified having terrible nightmares. It happened two years ago, but I still suffering of ICU PTSD. Of course, I believe that most of the nightmares were influenced by the fact that I was gunshot in my head, so, to me, everyone wanted to kill me.
Josefina
I went through a very traumatic illness including quite a bit of delirium while I was in a coma. I have written on my blog about my memories from that time, which are hazy but specific enough that the ‘awake’ people around me corroborated some of the events. It seems that in every bit of delirium I had, there was always a touch of truth or fact – and then my brain just filled in the blanks with whatever else it had on hand at the time.
I beg anyone working in the medical field to assume the patient you are working with can hear you. I was lucky that many of my caretakers did, which gave me an anchor to sanity during very confusing times. You can make a enormous difference in whether a coma becomes a trauma or just an enormously tough experience. There is a difference.