The 4 East ICU is a 6 bed intensive care unit for psychiatric patients who require the highest level of care possible. Our ICU team deserves the Daisy Award for our commitment to excellence. Here is a case example of our teamwork!
We admitted MV, an 18-year-old non-verbal male with severe Autism, Developmental Delay, Cerebral Palsy, C. diff, and urinary retention in June of 2014. He had been very aggressive prior to admission: he kicked, hit, bit, and charged at staff relentlessly. We quickly developed a plan of care to address his medical, behavioral, and psychosocial needs. We ordered special foods as we learned what he preferred and used special foods as a reward for good behavior. He loved ketchup and would smile as he smeared it all over his room. He also loved to shower and would flood his room often. A major challenge in meeting his hygienic and medical needs came as he was indiscriminate with whom he would lunge toward, often with fingers covered in feces. His room needed to be cleaned regularly throughout the day as due to smearing C. diff stool throughout his room. Here is where our teamwork began to shine. During periods of incontinence or providing necessary medical care, we would prepare to enter the room as a team. This became somewhat of an isolation gown ritual in which we helped each other take necessary precautions and held each other accountable as we would strategize the most efficient and caring way to meet his needs. When he needed to be catheterized due to urinary retention, we would explain our procedure and gently hold him in place to prevent contaminating the sterile field and striking out behaviors.
Each member of our ICU team fell into place without complaint, sharing the workload and entering the room as a team. The male staff did the majority of the hands on care due to periodic aggression while the female staff would skate around his room on bleach wipes, yielding wipes in each hand to clean walls and other surfaces. Each shift made a point of ensuring all care and cleaning was thorough, leaving MV with fresh linens and a safe environment for the next team to inherit.
Thanks to all of our teamwork, MV’s stay was a success. His behavior and hygiene gradually improved with a regular schedule, a reward system, and effective behavioral and medical nursing care. On 4 East ICU our team rocks!