Essay Sample about Nursing: Delirium in the ICU

Nursing care exhibited in the intensive care unit, of any given hospital, is care that must be provided with the utmost attention exhibited to every aspect of a particular patient’s care. Matters of care being provided to a patient in the intensive care unit can only be proven to be more difficult, given that 60% to 80% of patients admitted into the intensive care unit will be delirious upon arrival, or develop delirium during their stay (Vanderbilt). Delirium can be defined as “a rapid, serious, disturbance in mental abilities that results in confused thinking and reduced awareness of the environment” (Mayo Clinic). For the nurses of the intensive care unit, who are on the front-lines of patient care, have extreme difficulties providing care to delirious patients. However, nursing care for delirious patients is doable thanks to modern nursing interventions that can be performed in the intensive care unit. 

The main nursing intervention for delirium in the intensive care unit is quite obvious; prevention. Prevention of this debilitating disorder that occurs in seven out of every ten patients admitted to the intensive care unit, can consist of many different preventative measures. Some obvious measures nurses can take independently to help prevent a patient from developing delirium can be to limit the sounds as much as possible for a particular patient. While it may sound weird, the constant beeping that accompanies most every patient in hospital stays, can assist in speeding up the process of developing delirium (Medstar Health). Nurses in the intensive care unit can also create a tentative schedule with the patient to help limit the amount of times the nurse must interrupt the patient, as constant interruptions can also help the onset of delirium develop. The preventative independent nursing measures that can be done in the intensive care unit could create a very long list, however the constant interruptions and sounds tend to be the most detrimental when it comes to developing delirium. 

Most of the anti-delirium measures used to include the dependent nursing intervention of delivering antipsychotic medications, such as Haloperidol (National Library of Medicine). However, after an ample supply of level one research studies show, the use of antipsychotic medications can play little to no role in helping prevent, or even treat delirious patients, and sometimes actually exacerbate the given issue. Advocating on the patient's behalf in order for the doctor to strongly consider the use of Benzodiazepines is also a great nursing intervention that can be performed in the intensive care unit. Benzodiazepines are linked to drug-induced delirium in around 30% of delirious patients that are in the intensive care unit. Once again, the list of dependent nursing interventions to enact while working in the intensive care unit as a nurse to prevent or treat delirium in patients, could go on forever, but not using pharmacological measures seem to be a very effective way to prevent delirium. 

Nursing in the intensive care unit is quite different from other fields of nursing, especially when dealing with delirious patients. Nurses in the intensive care unit must focus on the long-term health goals and needs of patients (Nurse.org). In the intensive care unit, nurses are often only assigned to two to three patients, simply so that they can spend much more individualized care with each patient. Building rapport with the patient, and their family is also very important as nursing in the intensive care unit focuses on the health and well-being of the patient, long after their discharge. However, burnout for nurses working in the intensive care unit is quite intensive as around 45% of nurses will eventually develop burnout syndrome while working in that unit (ATS Journal). Nursing, by itself, in the intensive care unit is quite cumbersome, but throw in the fact that 60% of patients in this particular unit have delirium, the challenge only becomes much more difficult. Working as a nurse in the intensive care unit does have its perks however as it is one of the only nursing fields where you may get to watch patients who are very critically ill, progress into recovery. Overall, nursing in the intensive care unit and dealing with the common problem of delirium in patients, and many other challenges, has its positives and negatives, but is overall a very challenging and rewarding specialty.