Humanizing ICU Care: Role of Family Centred Care - Dr Himanshu Dewan

Development of advanced critical care units and intensive care medicine as a medical super speciality has had a massive impact on reducing patient mortality and morbidity. Some disease which were considered a doom for the patient such as celphos poisoning or severe ARDS have had a significant reduction in mortality due to modern day ICU’s and advanced machines.

The downside of all this development and technology is that the ICU’s may seem like a walled prison to the patient and his family. And times we clinicians are so busy in planning treatment for the disease that we overlook the fact that a “HUMAN” has this disease. This Human is scared that he may lose his life, he is scared that his family may not be able to support themselves in his absence. And recognizing this aspect of illness is what brings us close to humanization of ICU care.

Why does de humanization occur?

Imagine a scenario of a critically sick patient coming to critical care unit and being addressed by his bed number (rather than his name), he immediately lost his identity!

His family outside the ICU not being able to meet him due to visiting timing restrictions, he lost touch with his family! So, de humanization consists of treating someone as an “OBJECT” rather than as a “PERSON” and is often associated with failure to honour dignity.

How can family help?

Imagine you are 14 years old and first time in a foreign land. How scary can this get! And if you have a relative to guide you, it becomes so much easier for you.

Similarly, for most patient’s ICU admission is their first time encounter with a life-threatening situation and this fear gets compounded by the daunting sight of ventilators, monitors and medical jargon that they hear but not fully understand.

If such a ICU patient could have a family member at the bedside, his morale and confidence would surely improve. The sight of a familiar face and warm touch of his hand would motivate him to fight this disease along with the medical team.

Enhancing family involvement in ICU

Unlimited visitation rights for the family members would be ideal, but considering our healthcare limitations and at the same time not violating infection control protocols, one family member may be allowed to stay by the patient’s bedside for long periods.

This would help the family meet the treating doctors, understand the plan of care better. They would know the nurses better and the nursing staff would be able to know the patient as a person, and this would enhance the level of care provided.

Such patient and family centred critical care units are a need of today, and they would go a long way in improving patient care and satisfaction. And to quote from the 1998 movie PATCH ADAMS, "If you treat a disease, you may win or lose." You treat a person, I guarantee you, you will win, no matter what is the outcome.