Question
Does nursing support early mobility in the ICU?
Answer
At our institution, we have been very fortunate that therapy services has built a very solid rapport with our nursing staff to the point almost, where the nurses totally trust us. However, I will say that when we did start doing some of this research, and even now after we have completed it, we do meet situations where you get some pushback from nursing. What helps this is establishing our own risk benefit. You walk in the room and determine if the patient will benefit from what you are doing today, or is this something that could wait a day. From there, we can use our own thoughts to educate the nurse as to why it is important and help the patient to understand why it is important. Do we ever meet nursing resistance? Yes. I do think a lot of it is fear. It is scary to have a patient who is awake moving about with all the equipment, despite being very sick. The more we can educate nursing and physicians on this topic, it will only help us to be more successful with implementation of these ideas.
Marla adds: I have worked in ICUs my entire career and it had a lot to do with the competence of your staff. Developing clinical competencies that are validated by other therapists who are practicing in those areas, or if you are going to be using a portable ventilator, coordinating that with your respiratory therapy team to be able to have them involved so they feel comfortable with you utilizing equipment that is not always traditionally been part of a therapy realm will also enhance that collaboration. The other thing to do is start going to rounds and speak about what you are doing with the patients. That develops a lot of collaboration and rapport with everyone on the multidisciplinary team.