An exploratory study of patients' perceptions, memories and experiences of an intensive care unit.

In the research reported, 298 patients were asked to describe their memories of the Royal Melbourne Hospital's intensive care unit (ICU). The data were collected by either self-reported questionnaires or structured interviews and examined from a bio-psycho-social perspective using both qualitative and quantitative methods. These recollections demonstrate that the close surveillance by both technological support and health care practitioners provide many patients and their families with a feeling of safety. Patients' memories of ICU also highlighted the presence of power relations which are inherent in clinical practice. This paper provides examples of actions and remarks within ICU that were not only remembered by patients and their families but also continued to effect patients 6 months after their discharge. The data in this research indicate that some of the psychological problems experienced after discharge may have been prevented by improved communication between staff and patients in ICU. This study also demonstrated the importance of providing feedback to the nurses working in ICU. This feedback raised awareness of patients' perceptions of both ICU itself and the behaviour of the staff. It also reminded staff that some patients remember everything about their admission of ICU. The data indicate that while patients found the presence of good communication in ICU both therapeutic and reassuring, they found the lack of good communication distressing. Poor communication not only caused anxiety while the patient was in ICU but also contributed to less than optimal recoveries after discharge. Finally, it will be argued that the provision of information from nurses not only diminished feelings of anxiety but also empowered patients to become involved in decisions about their care.