Abhishek Bhardwaj, MD; Mark Mikkelsen, MD, MSCE; Alicia Ulerick, Julie Rogan, MSN; Megan Zielke, and Kate Melville, MD.
Many patients who spend time recovering in medical intensive care units (MICU) experience a range of difficulties, such as physical weakness due to long-term immobility; cognitive impairments in memory, attention, and problem-solving; and mental health disorders like depression, anxiety, and PTSD.
To combat the often overwhelming challenges associated with post-intensive care syndrome (PICS), Penn Presbyterian Medical Center’s MICU team has recently introduced healing journals in an effort to ‘bring meaning and life back to survivors of critical illness.’
Spearheaded by Julie Rogan, MSN, a clinical nurse specialist in the MICU, the healing journals aim to humanize the patient experience and help patients make sense of their intensive care experiences and piece memories back together. The journals have been popular in many European countries for years, and the evidence-based practice has been gaining popularity in the United States.
The MICU staff received a Bach Fund Grant to cover initial expenses of the project and worked with an interdisciplinary team to determine the best strategies to avoid risk management concerns. In addition to written entries contributed by both staff and loved ones, the journals include photos of the MICU from a patient’s perspective, for example, parts of the room they may have seen or machines they may recall beeping.
“The main goal is to help patients understand that they were never alone,” Rogan said. “Both their care team and family members are encouraged to write entries – reflections on their progress, positive and hopeful words. This helps patients understand that they’ve been surrounded by people who care and support them.”
Though the program has only recently made its debut, the journals have received rave reviews from family members. Rogan and the MICU team hope to continue developing the project by working with occupational therapists to help able patients write in their journals, as well as to create a peer support system among the patients and families.