ICU nurse tells how coma patients wake up

Submitted by Chilean Nurses Association
April 24, 2020

Notes from newspaper: Las últimas noticias, 23/04/2020

“Covid-19 patients arrive with much fear and anxiety about what will happen. Then, when they arrive at this unit and we – the nurses – tell them that we are going to have to intubate them, this procedure and everything that is going to be done is explained to them. They’re also given the opportunity to talk to their family at that time in case they want to tell them anything, because they’re going to be asleep, sedated for a while. Nurse Barbara de la Cortina, at Clinica las Condes, Santiago, Chile, tells us and who attends to COVID-19 patients that they are positive and adds, “there are patients who need vasoactive drugs to maintain adequate pressure, others need invasive or non-invasive mechanical ventilation, we’ve had patients for 30 years, but most are concentrated in the upper 50 years.”

Serious patients are intubated for about 14-15 days, “when they are extubated, they wake up disoriented, very afraid. They ask: what happened? How long was I  in a coma? Anxious, they say they want to see their families. So, as nursing professionals, we have been looking for methods of communication for them to have contact with their family, online, or with cell phones, to support them.

Other patients, says the nurse, realize they have a fever and think they are going to get worse. “As nurses, we give them permanent emotional support so that they can move from the critical state to a less complex unit.”

What do they say to contain them?

Well, we tell them that they were serious, that they were given the best care and that they are now better, the fact that they are now awake indicates a significant level of improvement, and that the worst is over. Even though he is a COVID 19 patient, we still hold his/her hand because we are with correct and adequate personal protection measures. .. We don’t have to lose the human part of care, shake their hands, touch them, and tell them that we are there for them. We also explain to them the things they are feeling: it is a catheter, it is used for this, and with this education we lower their anxiety.

How is it with patients who are not intubated on non-invasive ventilation?

They still feel isolated since they are not receiving visitors. In the emotional sense, they may suffer because they cannot see their families. We allow them to have a cell phone inside, or we give them tablets to communicate with their families. Also as nurses we have an emotional plan by stimulating them, giving them encouragement and the company they deserve. They are complemented by radio and TV in their rooms.

How do you prepare to treat and care patients?

We have separate rooms, each with its own door. Every time we go into that room, we have to prepare with personal protection gear. Outside the room we have to put on masks, goggles, hats, breastplate, and gloves. We always do this with a person who is supervising us.

How are your shifts?

We work in rotating shifts. One day we work the nurses from eight in the morning to eight at night. And the next day, from eight o’clock at night until eight o’clock in the morning, and two days off. And so again.

And finally, these tiring shifts are rewarded, says the nurse, but when she arrives at her home, she has had applause at nine o’clock at night when she arrives:” some of the neighbors look up at her balcony and thank her, and my heart is full,” she says.

Translated and adapted by Dr. Eugenia Urra M. (Chilean Nurses Association)