What to Do While the Patient is Unconscious
While each patient's unconscious experience is unique, there are some activities which are almost universally helpful.
HOW TO HELP
1. Encourage all of the emotionally positive people in the person's life to visit. Many patients report feeling the amount of caring these people bring with them. While most hospitals have policies that allow only the immediate family in ICUs, this policy is intended to be for the well-being of the patient. Many hospitals are flexible if a visit from a close friend or even a pet would be helpful.
2. Similarly, try to discourage or prevent people from visiting who might drain your patient with their negativity. Abusive parents and spouses should not be allowed to visit. At the moment, your patients can only protect themselves by retreating further into their unconscious state. This is the opposite effect to what you are trying to achieve. This advice is particularly important if your patient is suffering from a distorted perception of the situation. If they already think they are being held captive, the presence of someone who has brought them harm in the past exacerbates the situation.
3. Remember that your patients may be able to sense many of things going on around them. They may be able to hear, feel, or even see you. Because of this, try to talk to, not about your patient. If they are unable to communicate with you, but can still sense what is going on around them, they are most likely very frightened and frustrated. Even reports of the seemingly inconsequential occurrences at home may give them great comfort. It is extremely important to remember this suggestion, as many patients report hearing most discouraging comments. Always treat them as if they are completely awake.
4. The above advice is particularly important to remember when unconsciousness has just occurred, the patient is coming out of unconsciousness, or has just been moved.
5. Remember that your patient's personality has not changed. If they did not like sports on television before they became unconscious, they do not like it now. Try to arrange the environment in the way your patient might if they were awake. If they have always enjoyed physical contact, like hugging or holding hands, have the family keep doing that. Try to be aware of their likes and dislikes in the past and try to arrange the environment accordingly.
6. Ask the family to bring in photos of your patient doing activities that are important to him/her. The photos can help you and the other staff understand your patient more as a person.
7. If your patient is struggling against their tubing, or trying to get out of bed, they may be suffering from the previously discussed distorted awareness. Remember that this is very frightening to them. Remain very calm and keep explaining to your patient where they are, what is happening to them, and that you are there.
8. Maintain a schedule similar to that of the patient's normal routine. If he/she is an early riser, let the staff know and have them promote the same schedule.
9. Watch for signs of awareness. While some research is being done to detect awareness through sophisticated equipment, what you observe can be very meaningful. Some early signs of awareness can be observed in facial expressions, eye expressions, and appropriate tears.