Keeping Calm During the Storm; Anxiety in hospitalized Patients in the ICU

Alexis T. Fellows

Saginaw Valley State University

NUR 302: Introduction to Baccalaureate Nursing

Holly Tews

7/28/2024
 Keeping Calm During the Storm; Anxiety in hospitalized Patients in the ICU

To begin my analysis, we all need to think about putting ourselves in our patients' shoes, so

imagine, or think of at the time that you were admitted to the hospital for some reason. In my scenario,

you may have had a headache where they could not figure out the cause and you had other

comorbidities that required additional testing and monitoring. Personally, I would be frightened. I have

never been hospitalized for anything, but my background is that I am a young healthy 24-year-old

female. My anxiety is controlled with Me knowing what my limits are and what my triggers are, to help

me avoid falling into overload. But I think being admitted to the hospital would contribute to my anxiety

heightening. I feel that may be the case for most people. A lot of humans already have a healthy dose of

anxiety present in everyday life.

In my research, I wanted to look at reducing or relieving anxiety in hospitalized patients,

professionally called nursing interventions. There are many different interventions that can help our

patients with this and as nurses one of our many goals should include helping our patients be as

comfortable as possible with the situation at hand.

Definition

Anxiety is a vague uneasy feeling of discomfort or dread accompanied by an automatic

response, the source of which is often non-specific or unknown to the individual. It is a feeling of

apprehension caused by anticipation of danger. (American Psychological Association, 2021). It is also an

alerting sign that warns of pending danger and enables the individual to take measures to deal with that

threat. (Jovanovic, 2018).

crippling to another, it may just be a slight feeling. In general, I just would like to examine anxiety in

patients in the Intensive care unit and interventions to help them feel more comfortable.

Literature Review

The first article I am looking at is helping with anxiety during transition from Intensive care to

general units for the patient and their families. Most patients that are admitted to ICU can be hard to

assess for satisfaction, because of things like reduced level of consciousness. Transition nursing practice

can create a deep impact on the patients experience overall, by bridging care with nurses, doctors,

physical and occupational therapy, speech therapy and all the other interrelations that participate in

care, it can also make positive changes to better meet the needs of our patients in the ICU and their

families. This protocol includes care, education, rehab, and mental/emotional support. With the goal of

minimal disruption and continuity of patient care. The research was conducted on 50 patients and their

relatives, before- then immediately after, 8 hours, 16 hours, and 24 hours transition was complete a

liaison nurse had the patient fill out a Spielberger anxiety questionnaire. With this transitional nursing

practice anxiety was shown to be reduced and satisfaction increased. So, this would be a beneficial

policy to be instituted in hospitals to help. I feel a form of this is the report we pass on nurse to nurse in

the hospital, or when moving patients to a new hallway, providing all the information to the next person

caring for this individual. (Ataeeara et al., 2023).

The next article on interventions that I researched for ICU patients was having a care companion

present while patient was in the ICU, family and loved ones being present and their effect on the

patients affect is still being researched because it can be negative, positive, or both. Family dynamics are

all very individualized. In this study all random 48 patients were studied, half had patient companions
(loved ones) present for 30 minutes and contribute to their clinical primary care. The other half did not

have companions present. Anxiety was measured with the State-Trait Anxiety Inventory before and 3

days after the study began. It was concluded that anxiety was reduced in both cases, however, it was

more drastic in the intervention group. After this study, it is obvious that having the scheduled

companion involvement can help in a nonpharmacological way to reduce anxiety in those ICU patients.

Something so simple as to include their loved ones in the care of the patient is such a small thing that

could make a substantial difference in the patient's anxiety, why would we not try this? (Fateme

Biabani et al., 2021).

The third article on interventions for ICU patients that I reviewed wanted to look at improving

sleep quality. The study found different things like noise, light, temperature and humidity, pain, sleep

deprivation, and clinical care disturbances to be the most common causes of impaired sleep cycles. After

finding out the things that caused this to happen the study looked at sleep promoting strategies things

like reducing noise and minimizing disturbances, patient and nurse collaboration, educational and

behavioral change the use of eye mask earplugs and complementary treatments, and pharmacological

interventions. Not having quality of sleep can affect the body's ability to heal and for the patient's brain

to have rest. Noise and disruption from the medical staff seemed to be the most common cause of

patients not being able to sleep well, something that facilities have the ability to change in their

medicine passing and routines. This is a great non-pharmacological approach. It is modify-able and

theoretically through staff education can easily be implemented to help our patients sleep better and

contribute to a healthier patient outcome. (Aparício & Panin, 2020).

The last article I researched for my topic considered music therapy being a choice of treatment

for relieving anxiety in ICU patients, this was umbrella research conducted on many different ages,
genders, and conditions. There are many different symptoms like pain, trouble sleeping, anxiety, and

stress, however it was found to be the most effective in anxiety treatment. In this research the

Spielberger State-Trait Anxiety Inventory, the Visual Analog Scale (VAS), and the Faces Anxiety Scale. The

music needs to consider the culture and background of the patients but mostly using low tempo music

or relaxing music like jazz or natural sound music was the best choice for the treatment. There were

many different lengths of treatment examined from 10-240 minutes (about 4 hours) but 20–30-minute

sessions were enough to be effective, music therapy is used to treat many different scenarios but for

this umbrella review found that this is an effective treatment for relieving a lot of uncomfortable

symptoms of being in the intensive care unit. (Golino et al., 2023).

In reading these articles of studies conducted, I have found a correlation between what soothes

me also does help soothe others to, these methods have been proved in trials that have been conducted

and have been shown to reduce anxiety in these patents in the intensive care units. It is nice to be able

to know that if you have a patient struggling to cope with the stress and anxiety of being in the intensive

care unit, you can ask yourself what would help you feel more comfortable, or what would you want in

this situation? And see if the patient would like to try different things to ease these emotions.

Lifespan Considerations

Anxiety can affect us all, in diverse ways, on various levels. You can be empathic with your

patient about the feelings but may not totally understand what they are experiencing. Children, for

example, are not emotionally mature enough to recognize and verbalize what they are feeling. They may

show different signs than an adult like- Crying, acting out, and rejecting care. They have unique needs to

help them be comfortable and reduce their anxiety some may include showing the equipment to them

and letting them play with it and become familiar, or demonstrating procedures, they may need to have

their mom or dad right next to them to feel safe and reduce their anxiety. In other instances, many

adults can verbalize how they feel and what they are feeling, they may not have the skills to cope and
may not be thinking clearly enough to figure out what they need to reduce their anxiety. Thats when we

need to produce suggestions to intervene with to help them. For example, what the research I found

mentioned, having a friend or family member with them, listening to music, helping make sure they are

getting adequate sleep, and overall listening to the patients. A new mother may have diverse needs than

an adult, she may need reassurance to let her know she is doing well, help learning new ways of taking

care of a new baby like feeding changing diapers, or just being worried about being responsible for a

new life. Becoming a new nurse, we need to understand that it is more than just taking care of our

patients we are also helping to take care of their families by reassuring them and comforting them,

preventing them from worsening our patients' emotions, a lot of our patient's source for anxiety can

stem straight from their loved ones feelings, making their anxiety worsen, so taking care of their family

is just as important as taking care of them.

In conclusion, nurses can make a dramatic difference in the anxiety levels of patients, with many

other proven ways other than giving them medicine. Figuring out and understanding your patients is key

in helping them be comfortable with what is going on and understanding what is happening around

them. Active listening can help develop a trust and bond between nurse and patient. Practicing this skill

will help ease your patients, and help you be the best nurse you can be.
 References

American Psychological Association. (2021). Anxiety. American Psychological Association.

https://www.apa.org/topics/anxiety/

Aparício, C., & Panin, F. (2020). Interventions to improve inpatients’ sleep quality in intensive care units

and acute wards: a literature review. British Journal of Nursing, 29(13), 770–776.

https://doi.org/10.12968/bjon.2020.29.13.770

Ataeeara, S., Jahani, S., Rashidi, M., Asadizaker, M., Maraghi, E., & Najafi, S. (2023). The Effect of

Transition Nursing Program from Intensive Care Units to General Units on Anxiety and

Satisfaction of Patients and Their Families: A Clinical Trial Study. Evidence Based Care Journal,

2008-370X, 7-14. https://eds.pebscohost.com.svsulibrary.idm.oclc.org/eds/

pdfviewer/pdfviewer?vid=4&sid=97beb2a0-863e-4c6b-863b.a4c1a80b65e5%40redis

Fateme Biabani, Samaneh Bagherian, Maryam Salmani Mood, Hossein Sanaei, & Marzieh Helal Birjandi.

(2021). The Effect of Scheduled Care Companion Program in Primary Nursing care on Patients’

anxiety in Cardiac Intensive Care Unit. DOAJ (DOAJ: Directory of Open Access Journals).

https://doi.org/10.22038/ebcj.2021.59622.2544

Golino, A. J., Leone, R., Gollenberg, A., Gillam, A., Toone, K., Samahon, Y., Davis, T. M., Stanger, D.,

Friesen, M. A., & Meadows, A. (2023). Receptive Music Therapy for Patients Receiving

Mechanical Ventilation in the Intensive Care Unit. American Journal of Critical Care, 32(2), 109–

115. https://doi.org/10.4037/ajcc2023499

Jovanovic, T. (2018, November 15). What Is Anxiety? Anxiety.org. https://www.anxiety.org/what-is-

anxiety