Comments on: What I wouldn’t do for earplugs

By: Jordan

Jordan — Thu, 20 Nov 2008 20:21:54 +0000

Wow, what was stress releasing vent morphed into an interesting ICU psychosis in-service. I had no idea it was so common.

On another note, I have noticed a difference between ICU nurses attitudes and Med-Surg nurses attitude. One of my co-workers transferred from the ICU to the floor, and I remember going with her to visit the ICU and they are much more serious. I laughed at my co-workers joke, while her ICU friend took it seriously. It’s a totally different mind-set.

By: Lorraine

Lorraine — Sun, 10 Feb 2008 16:00:24 +0000

Welll.. What about the profoundly-deaf patient with ICU psychosis? He’s abt 43 yrs old. Can’t hear a thing without hearing aides. The sounds of the ICu are not his problem, the lights and touching is.. Any comments?

By: sherblanton

sherblanton — Mon, 24 Sep 2007 23:28:20 +0000

Noise in the ICU is a HUGE subject. The research on the subect is quite interesting. Noise in ICU’s can reach 60-80 decibels. (Well over the OSHA safety zone). The noisiest periods are from 12-6 am. Machine noises are actually the worst noise for patient (alarms) - those noises really crank the stress responce into high gear. The most important fact to remember is that in critical care units “Silence Kills” and it can kill a patient alot faster than noise can. I remember a story a nurse (Mz. S)who left our unit recounted to me. She was totally unaware that she was in micro-sense recounting what fairly good research has found to be true. . . . Anyway, the story goes like this:

Mz. S goes to work in a unit in which the nurse manager strongly disapproves of noise. She insists on a “quiet healing enviroment”. The nurse manager tromps down hard on anyone to enters into any social discussions or conversations during the course of the day.

Mz. S finds an interesting phenomenon accompanies the quiet . . no one acts as a team when a patient is circling or going down the drain. She is on her OWN when a patient is going bad. She also notices that no-one discusses processes that aren’t working well or are dangerous - they just keep doing the same stupid things over and over again.

Mz. S left that ICU unit. Lots and lots of nurses left that ICU on a fairly regular basis.

Mz. S found a new ICU unit to work in. On her first day in the new unit a group of nurses and a couple of residents were discussing how many pencils one of the nursing supervisors (who was rather well endowed) could hold under her breast if her bra was off. The well endowed nursing supervisor was also participating in the discussion. The group was very collegial and invited Mz. S into the conversation immediately. Mz. S knew she was home. When her patients need a “village” to save them, she seems to get the team work and professionalism that is needed.

The name of your post is interesting. Earplugs for patients are the only process measure that have been found to reduce the noise in the ICU on an ongoing and consistant basis. Earplugs can keep the conversations going that need to be going and the patient can get the “quiet” they need. Being rude and “hushing” people doesn’t usually work unless your institution intends to hire a 24-7 “HUSH” police force. “Hush” is not a process measure for improvement. It’s a means to practicing your nursing recruitment measures . . over and over and over and over and over and over and over . . .

By: Bear

Bear — Thu, 28 Jun 2007 19:22:07 +0000

I worked in ICU eons ago and remember the psychosis well. Has anyone ever tried earplugs for the patients? Something that may dull the roar of the beeping, the docs, and the nurses at least enough to catch a bit of uninterrupted sleep. It is cheap and at least worth a try. Especially for those who are lucid today…maybe it would keep the psychosis to a minimum.

By: Monica

Monica — Fri, 09 Mar 2007 13:44:22 +0000

My dad had quadruple bypass surgery 10 days ago. He came through with flying colors; however, two days after surgery he was having difficulty breathing and was moved to the ICU. He has been in ICU for 6 days. After what I have read here, he is definitely experiencing ICU psychosis! His nurse, a remarkable young man, explained to my family what my dad is experiencing, but it is very difficult to watch him in this condition. I certainly pray that this condition is temporary and once in a regular room he will become more coherent and aware of his surrondings.

By: Ken

Ken — Mon, 05 Feb 2007 21:25:23 +0000

My Dad had quadruple bypass surgery 8 days ago. I have been reading about post operative pshchosis and it appears that he is suffering from the same. He does not remember anyone being there, calls my Mom who spends the day with him screaming at her why she did not come there and why she won’t take him home. This is completely out of character. He raised his voice only at misbehaving children only through is 82 years. Any one have any words of comfort or suggestions on what to do to bring him out of this??
Thanks, Ken

By: JoAnn

JoAnn — Thu, 02 Nov 2006 21:12:18 +0000

I’m amazed at all the info on icu psychosis. It has been quite an education reading all of these posts. GEENA - I got your message, and you just keep on doing your best. It’s all any of us can do. I’m researching this topic b/c my Mom has been in ICU for almost 2 weeks, and seems to periodically be someplace else, or just not in the here-and-now. I’m thinking family pics will help, and lots of visits. But, seems like sleep is the main thing that will help. Anyway, thanks - I have learned so much from your blog!

By: Judy

Judy — Sun, 29 Oct 2006 09:46:46 +0000

My sister has been in the ICU for almost a month now. She almost died twice. She is being treated for a brain tumor and she contracted some kind of lung infection due to her weakened immune system. She’s been psychotic since she came off the respirator - that was five days ago. It was funny at first and we were so relieved to hear her talking at all that we weren’t all that concerned. It’s not funny anymore. The information here has helped me a lot. I never heard of ICU Psychosis before. My family will be very relieved when I tell them what I have learned here. I’m going to try to make sure she at least can see out the window during the day and, even though it’s the nurse who’s wishing for earplugs in this post, I wonder if they might help my sister sleep at night. I’ve been in the hospital before and I know what all those noises can do to your nervous system when you’re medicated. Anyway, thanks for this posting and best of luck to all!

By: jennifer

jennifer — Sun, 29 Oct 2006 02:30:27 +0000

Why haven’t we heard about this before? Seems like we should all be warned that this can happen — I’m so glad to have found this thread.

My mom had complications after knee replacement surgery and ended up in the CCU, though she started going loopy just the day after her surgery (before ICU). Does it have to be an ICU to be ICU phsychosis?

By: M

Fri, 27 Oct 2006 01:45:33 +0000

My dad recently has surgery for testicular cancer. He was only supposed to be in the ICU for 2 or 3 days but with various complications, he stayed in until day 7. By day 5 though, he was suffering ICU psychosis. He sees his cat on his lap and he thinks that everyone is out to get him, the “lawyers” keep on coming in. Thanks for this post because this condition was the scariest thing we experienced so far. In the morning he was fine and joking with me and by the night he was calling me over and over to tell me about the huge settlement he was getting. The comments from above are really strange that reference you going on vacation, in no way did I see that you were complaining, who would complain about this condition. If I was tied up for a week on opiates in a loud room, I would go crazy too.