Thread by @laxswamy

I love working in the ICU. So much of what we do is just trying to reduce the harm we inflict keeping people alive long enough to either get better or not. The harm is immense despite that ... 🧵

cw: icu trauma

https://twitter.com/drjessigold/status/1359851087436644353

ICU patients, more than most any other, lose autonomy. Most icu patients can't make decisions about anything- either you're sedated or too confused or otherwise incapacitated. Imagine having no say in whether a needle goes in your body.

I'm not even talking about the really invasive stuff. Imagine having literally no say about how your body is positioned, turned. No control over your bladder or bowels. No control even being awake or asleep.

Imagine not even being able to withdraw your hand when we prick your finger for blood glucose levels. Over and over and over again.

Imagine not being able to say no.

Do you trust the people in scrubs are looking out for you? Is it even possible to trust when you're floridly delirious? I imagine all that matters is enduring the terrible experience.

https://twitter.com/laxswamy/status/981970938479640577?s=19

I *love* working in the ICU. I think we have the chance to make an incredible difference in the lives of patients and their families. We mix science, technology, and empathy every day. To the max. But it is brutally hard to know that despite our efforts, patients suffer.

I often describe this to new families in the ICU. We can do absolutely incredible things, sometimes. We can save lives that would have been lost ten times over... Sometimes. But it is always at some cost to dignity, some very real suffering.

All of us, especially icu nurses, do so much to maintain dignity. To limit suffering. But we know we can't really prevent that harm, and we know patients are suffering. More and more the longer they stay with us. It definitely gets to us

So these results aren't surprising at all to us. Even though I love working in the unit and consider it an immense privilege... It is rough as hell for our patients. I hope we can learn to do better. We have a long way to go... But we are doing our best. 🙏🏾

Re dignity and suffering, I do try to bring this up at the very first meeting.

https://twitter.com/laxswamy/status/1139946671528456192?s=19