Patients' memories from intensive care unit: A qualitative systematic review.
Charlotte C Maartmann-Moe, Marianne Trygg Solberg, Marie Hamilton Larsen and 1 others
PMID 33611859WHAT IT FOUND
ICU survivors remembered surreal nightmares, frightening hallucinations and feeling unsafe when nurses seemed busy or impersonal.
They also remembered nurses as safe when care was warm, reassuring and helped them communicate. These are themes, not tested effects.
Key findings
01The synthesis identified three themes: memories of surreal delusions and dreams, care memories from sanctuary to alienation, and memories of being vulnerable and close to death.
02Patients described surreal memories as the most distinct and scary, with nightmares, hallucinations and blurred reality.
03Nurses were remembered both as sources of safety and as sources of fear, including warm touch, reassuring words, feeling ignored, or forced through procedures.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review synthesises patients' memories, so it cannot show that any nurse action caused distress or that a practice change reduces symptoms. Included studies varied in quality, and some did not describe the researcher's own context or influence. Searches were limited to English or Scandinavian languages, and all studies were from high-income countries. Interview timing varied widely, from 48 hours to 10 years after ICU stay, so memories may not be comparable. The review included only patients' reports, not nurses' or families' perspectives.
Declared interests
The authors declared no conflict of interest.
The easy way to misread this
Do not read these themes as evidence that particular nursing behaviours caused PTSD or that changing them will reduce distress. The review synthesised patients' memories, not tested interventions, and all included studies were from high-income countries.