Patient perspective: Gordon Sturmey and Matt WiltshireBMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m1814 (Published 06 May 2020) Cite this as: BMJ 2020;369:m1814
Having both been long stay patients in an intensive care unit (ICU) in the 2000s, we understand the importance of physical and psychological rehabilitation after discharge.
We were some of the lucky few that could attend a follow-up clinic (run by the Royal Berkshire Hospital),1 which in the long term improved our quality of life as well as, we believe, reducing our chances of needing to call on the services of the NHS. It’s difficult for us, even with our experience of ICU stays, to comprehend the trauma covid-19 patients are suffering now and will suffer in the future.
We envisage two particular challenges for these patients. First, the lack of contact and support from relatives and friends while in ICU: after discharge these can, in more usual circumstances, help fill the gaps in a patient’s memory, giving a clearer understanding of an ICU stay. Second, dealing with the visual images of staff in full personal protective equipment (dehumanising the staff, in the eyes of the patients) will add an extra dimension to the hallucinations and nightmares that are prevalent in ICU.
There may therefore be greater need for rehabilitation after a covid-19 ICU stay, and it’s vital that a support network be put in place, especially with the exceptionally high number of cases. Ex-patient and relative support groups can help with this burden in conjunction with sponsoring hospital ICUs, as the importance of interacting with others who have been through a similar experience cannot be underestimated.
It should also not be forgotten that a support structure will be needed for relatives suffering from the experience of not being there when their loved ones most needed them (this will also affect the patients)—and, in some cases, the knowledge that they were unable to comfort them in their last hours.
We have read and understood BMJ policy on declaration of interests and have no relevant interests to declare.
Provenance and peer review: Commissioned; not externally peer reviewed.