A valuable lifeline during ICU lockdown

One of the most striking things that came with the COVID-19 pandemic in our department was the lack of people.

Obviously we still had a unit that was inundated with patients, and a host of new staff, but we lost those that are arguably the most vital to a patient’s stay in ICU: we lost their loved ones. This wasn’t obvious at first, but as time crept on there was an eerie silence masked only by the beeps from the equipment, the buzz of normal conversation a distant memory.

Early on in the crisis, our department had the foresight to purchase 30 iPhones to enhance communication between ‘yellow’ and ‘green’ zones. When they hit the floor, my colleagues were quick to introduce new uses, of which the best was video-calling relatives.

I’ll never forget the image of one of our patients waving down the iPhone at his children and silently mouthing “I love you”. 

Lockdown has made us all increasingly reliant on technology, being our source of education, communication and entertainment throughout this time. From the elderly in isolation ‘Zooming’ their grandchildren, to teachers giving virtual lessons, every generation has been thrown in at the deep end of technology.

The same can be seen in our ICU. It’s now a common sight to see a colleague holding a phone up to an intubated patient’s face, bridging the gap that telephone updates can never cross. One cannot help but overhearing the heart-warming messages of love and support from the quarantined at home as they reconnect with their missing family member. Furthermore as patients start to recover, they are able to communicate back. I’ll never forget the image of one of our patients waving down the iPhone at his children and silently mouthing “I love you”. I can’t imagine what that feeling must have been like for his family, after weeks of worryingly slow progress, to finally see him awake and responding. I think their reactions tell this story much better than I ever can.

Bedside manner is a critical part of patient care, but this is difficult with the restrictions of PPE and normal visiting.

The possible communication goes beyond connecting loved ones. On Easter Sunday, although we weren’t allowed to have a chaplain come, one of my brilliant colleagues organised a virtual spiritual visit, providing hope and a tie to the outside world.

Throughout this time, the use of video calls and the overwhelming support from the community has been genuinely uplifting. However, it is vital that we do not underestimate the strain of lockdown in ICU. Like most centres, we’ve had our fair share of untimely deaths, and often we haven’t been able to have people’s relatives there at that time. In these circumstances, it’s been possible for relatives to say goodbye or a last prayer using the phones. Though this is by no means sufficient in a ‘normal’ world, during this time it has provided a measure of comfort and closure.

Bedside manner is a critical part of patient care, but this is difficult with the restrictions of PPE and normal visiting. In a bid to flatten the curve, it is easy to overlook the value of seeing someone, fulfilling their spiritual needs, and looking after them as a person, not just a patient. Whilst video calling isn’t the all-encompassing solution to this situation, it has made a substantial impact to our patients and staff, and I cannot recommend it enough. This use of technology has been a valuable substitute for the human interaction that is so necessary alongside medical interventions.

Dr Benedict Shinner
Foundation Year 2 Doctor
Queen Elizabeth Hospital, King’s Lynn