Does Nursing Support Early Mobility in the ICU?

Does nursing support early mobility in the ICU?

At our institution, we have been very fortunate that therapy services have built a very solid rapport with our nursing staff to the point where the nurses almost totally trust us.  However, I will say that when we started doing some of this research, and even now, after we have completed it, we do encounter situations where we get some pushback from nursing.  What helps with this is establishing our own risk-benefit analysis.  You walk in the room and determine if the patient will benefit from what you are doing today, or if this is something that could wait a day.  From there, we can use our own thinking to educate the nurse as to why it is important and help the patient to understand it.  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 educate nurses and physicians on this topic, the more successful to will be in implementing these ideas. 

It had a lot to do with your staff's competence.  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.