Non-Clinical Factors that Help Create Positive Outcomes?

[marqpdx]

In June 2007, my family survived two weeks in the PICU when our oldest son nearly died falling out of a tree. The staff were to the point of discussing among themselves whether to begin counseling us about the possibility of removing him from life support and letting nature take its course.

Since that very, very low point in our lives, our son has made a remarkable recovery, and is now back at school, riding his bike, being an 11 year old boy.

Since then, i have written a booklet to help families survive ICU, have spoken to residents at OHSU about Parenting in the ICU, am building ways to help nurses and doctors with Debriefing Grief and dealing with High-Intensity Communications issues and am educating myself about Family Centered Critical Care.

I am intensely interested in discerning the non-clinical factors that help create positive outcomes for patients and families. We had an amazing (to many, surprisingly so) recovery, and i want to understand if there are ways to help other families (and the nurses that support them) achieve a similar miracle.

My question to you (i'm not a nurse, just a very very interested father) is:

what do you think are the key contributing non-clinical factors for healing and recovery in the PICU?

Thank you for taking the time to consider this!

Many smiles,

m

[NotReady4PrimeTime, RN]

Welcome to the PICU forum at allnurses.com. Thank you for your high regard of who we are and what we do. I'm so glad to hear that your son has recovered from what should have been a devastating injury. Your story isn't as uncommon as many would have you believe... we see miracles every day. They're what keep us on the job!

Hmm, key contributing non-clinical factors... Hope. We try not to shut the door on hope, even when it looks like the child can't possibly recover. That ties in with faith in a higher power, whatever the family sees as such. Some are very spiritual and have an abiding faith in their God. Prayer and providing an environment that supports the practice of familiar rituals are important. Recognition of the resiliency of children allows both hope and faith to exist. Kids are a lot tougher and more adaptable than any adult I've ever known. They bounce back intact from things that would have killed a mere grownup. They don't recognize their limitations or allow them to hold them back from doing what they want to do. Another factor that can't be discounted is the inclusion of the family in the provision of care. Giving parents and siblings roles in caring for the sick child keeps the family connected. Sometimes the connection is more ephemeral than physical, but no less real.

My personal experience tells me that miracles aren't really miracles but the confluence of many factors that can't be quantified. I live with a miracle, my own son who should have died half a dozen times before he was 6; he's now 25 and is the happiest person I know. He has challenges but isn't worried by them; every day is a gift. Many of the "non-clinical factors" I was exposed to as his mom back then, long before I became a nurse, are the very things I bring to my work every day. About 18 months ago I reconnected with one of the nurses whose care made such a difference to him and to me; we hadn't seen each other in 18 years, but it was as if it had only been last week. She remembered so many things from that time and when I told her that she was my role model, she burst into tears. I model my practice after hers and look for miracles in each child I touch.

[PICURN74, ASN, RN]

Glad to hear your son pulled through! Where I work we have a general hospital wide orientation followed but nursing specific orientation when we first get hired and then we are given additional instruction throughout our employment. One of the things that I found really helpful when I first started was hearing what it is like to be a parent in the ICU. We have something called patient family advocates, mostly parents of former patients or current long term patients, that are actually on staff and that tell their stories, answer questions and give suggestions to new nurses, doctors and other members of the health care team. They are also available to talk to families that are currently going through it because it is nice to talk to someone who has been in their shoes. I know the families and staff love it.

[Jolie, BSN]

Bless you for your interest in helping other families!

My experience in the NICU has taught me to appreciate the value of prayer.

Of course, not every family desires this type of support, but if they express an interest, please support it in any way possible. I vividly recall one infant for whom we held no hope of recovery and anticipated a very poor quality of life. Not surprisingly, his parents marriage was falling apart at the seams. A family member mentioned one day that he had become the subject of an international prayer chain and that family members and strangers around the world who were praying for him. He began to improve. Slowly but surely. He was discharged without the disabilities we were certain he would have. A co-worker ran into the family a few years later and was amazed by his normal growth and development and how happy his parents seemed.

Medical science could not explain his recovery.