Impact of having an Intensive Care Unit admission with severe COVID-19

Frightening memories of intensive care (ICU)

Over the COVID-19 crisis ICUsteps have received many desperate messages from recently discharged Intensive Care Unit (ICU) patients. So many of them didn’t know where to turn to cope with the nightmares and flashbacks they were experiencing. They had memories from their time on ICU of hallucinations and feelings that the ICU staff were trying to kill them. As a charity ICUsteps was established in 2005 to help ICU patients and their families recover and cope with such severe illness.

Extremely frightening memories of ICU are very common but each patient feels like they are the only one going through it. Normally ICUsteps run drop in support groups and there are more than 20 separate groups around the UK and Ireland. Unfortunately following lockdown these support groups could not meet and so a few of them moved to virtual Zoom meetings.

Virtual ICUsteps support groups

ICUsteps Chester was the first local group to run a support group using zoom. I normally manage the research programme for ICUsteps but my background is as an ICU nurse consultant in rehabilitation and psychotherapist so I offered to help. ICUsteps Chester were the first local group to support their normal attendees to login to Zoom and after some technical issues the meetings went smoothly. I was then able to direct distressed ICU patients contacting the national ICUsteps charity to join a meeting as geographical location is not relevant. ICUsteps Chester decided to meet weekly to help everyone cope with the crisis. You could see the relief new patients felt as they attended the Zoom meetings and realised that they were not the only people who had had these frightening experiences. Other local groups, in Edinburgh, Newport, Brighton and Dublin have now also started Zoom meeting.

Physical rehabilitation

ICU patients lose a lot of muscle during their illness as their bodies try to fight off the illness. This leaves severe muscle weakness and fatigue, even in people who were really fit before their admission. There are very few hospitals with rehabilitation services and community physiotherapy is extremely stretched at the best of times. ICUsteps has produced an information booklet about recovery for patients and relatives.

A number of the local ICUsteps groups have produced exercise videos for recovering patients, which are available on YouTube. During the COVID-19 crisis ICUsteps Chester have gone one better, running Zoom exercise classes and yoga sessions. These have been very popular and mean that recently discharged patients have been able start to regain their strength.

Impact on relatives

Most relatives of ICU patients during the COVID-19 crisis have not been able to be with their family member and may have been told over the phone that they might die. This is an awful experience and distressing for both the staff and family members. Some ICUs organised the chance to speak to the patient, before they were sedated and put on a breathing machine, using FaceTime or Skype.

There is information for relatives on the ICUsteps website about the ICU experience. But during this extreme experience many relatives were supporting each other on the online forum. So many relatives were looking for hope and information, ICUsteps Chester have started a virtual support group for relatives once a week to allow them to talk about their personal experiences without the patient being there.

Rehabilitation services

There are so many ICU COVID-19 patients and their families who need help to recover. So much money is spent keeping them alive in ICU but once they are discharged very few hospitals offer rehabilitation to help them get back to normal. Without such funded rehabilitation services many patients will not return to normal and lead blighted lives.