Pain relief in icu

It seems common sense to me that if there is a tube down, and lines in, and suction going on, that a person will be uncomfortable and in pain and should have pain relief.

I even looked up these guidelines for assessing pain in an unconscious person or a person who is 'waking up'

chpso.org/meds/sedation.pdf

So why do they subject a waking up person to hours and hours and hours of discomfort and pain in icu before extubating? No wonder everyone gets nightmares and pst. Patients are being treated worse than animals. This need to be seriously addressed.

10 Replies

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  • I'm so sorry you are having such a horrible, horrible time watching your Dad in ICU, but are you sure he isn't already getting pain relief, and sedation? He's probably in a nightmare admittedly, but it's not what the nurses are doing, he's on another planet, or at the bottom of the sea or something,. He's not sharing your nightmare. As for the nurses, you might get one or even two bad nurses if you're unlucky, but most are doing difficult things as kindly as they can. As for putting him a wheelchair and taking him away, he would certainly die.

    Are you keeping a diary for him? It will really help him later. And remember to listen to all he tells you of his nightmares, let him tell them over and over again and see how different they are from yours.

    I'm sure it's even worse to watch someone you love in ICU than to be there yourself. I hope your Dad gets better soon.

  • It seems that as a visitor you where seeing a very stressful side of ICU. It cannot be something that you can ever prepare for and all you want is the best for whoever is in front of you. My youngest son who was in his 20's at the time totally broke down and left the ICU and it took a little time to get back in.

    It seems that you have had an experience that needs to be looked into further? You have not mentioned when this happened and what follow up appointments have concluded or resolved.

    I notice the report is based in the USA, from what I have read to date is very interesting reading.

    I have a high pain threshold and morphine / analgesic tolerance so I am not the best person to add comments I have woke up in theatre twice.

    I personally have nothing but praise for the staff at both ICU departments at 2 different hospitals I was admitted to.

    I will say read though the various post on this site as time is still a good healer.

  • It Can be very difficult for relative watching their loved one's suffer with a critical illness, my wife spent 88 days beside my bed not knowing if I would survive, she has nothing but praise for the wonderful ICU staff that cared for me, always keeping her informed even calling her to the hospital on several occasions when things were not looking good, I cannot fault the treatment I received, I found them very professional and caring, I often go back to visit the staff and they are always pleased to see me. Sometimes counselling can help you come to terms with the trauma that both patients and relative go through, My wife and I had counselling together and it was a great help, I would recommend it to you, the anger and stress builds up inside you, looking for someone to blame, speaking to a counsellor can help you understand, feeling angry and guilty is normal but know one is to blame for a critical illness.

  • Yes after 3 weeks I am exhausted visiting ICU. Luckily the consultant on today gave sedation and pain relief to my father and so he is more comfortable and I feel so much better about it

  • But for 2 days before he had no pain relief. Or sedation.

  • Staff are good but by no means perfect and there is individual variation, for example in weaning off the ventilator There is also the tendency to actually be quite cruel in the name of clinical care in a way which is unnecessary. More people need to challenge current practice.

  • I can read how very upset and frustrated you are and I feel for you. As a patient, I had the easiest part of the ride, much less so than my relatives or the staff. My notes record me screaming in pain but I have no recollection of pain at all. There are pros and cons to sedation - too much can cause psychological issues but so can too little - as in countries like Spain and Italy where critically ill patients can be physically restrained and not sedated.

    Posters to the community, even healthcare professionals, won't be able to comment on specific patients without being involved hands-on with your dad's care. You clearly have concerns so talk to the nurse, the matron, the consultant and if you need to the hospital PALS service.

  • I dont want specific replies. I find the hospital staff very defensive and the fear of making a complaint or any criticism is that revenge will be taken against my vulnerable relative who is defenceless.

  • This is why it is very important that generally cruel practice is challenged in fora like this where there is a chance that practices can be changed for all patients

  • As a nurse I see your heartfelt frustration and pain. Please talk to the nurses and doctors caring for you Dad. Take care of yourself. Your Dad needs you well

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