“You Are Not Alone,” Comforting Message From a Nurse
by Valentina Mirto
| PTSD: My Story Project #013
I have chosen to participate in the PTSD: My Story Project because I am constantly exposed to people suffering from trauma due to being critically unwell. Sometimes trauma can be a silent enemy. And the fact that not everyone speaks about it may make you feel alone in this battle. Whilst you may not be aware of this, you are not alone.
Before you read my story, I would like to warn you that this may trigger feelings and emotions. Especially if you have been through critical illness, and have suffered or are currently suffering from PTSD post-critical illness. Now, if you feel safe, I would like to tell you a bit about me.
I am the first person people see when they wake up from a pharmacological coma. I am also the first person they would talk to if they had been critically unwell and were now working on their recovery journey.
This happens because I am not only a nurse in Intensive Care Unit but also a nurse who supports people recovering from critical illness. In order to explain to you what I do, I need to explain to you the correlation between PTSD and critical illness.
Critical Illness and PTSD
Critical illness often comes unexpectedly. And it can be a very traumatic experience due to the rapid sequence of events or the aggressive medical treatment that needs to be used in order to treat the cause.
You may be wondering what the link between PTSD and critical illness is. If so, let me take you on a short ride through Intensive Care that may help you understand.
People who suffer critical illness often get admitted to a critical care unit. Most of them will receive sedatives in order to induce a pharmacological coma. This practice is done for various conditions, such as respiratory failure, cardiac arrests, stroke and so on.
Being in a pharmacological coma (or medically induced coma) means that some of the normal functions of the human body get to rest while organs affected by the critical illness recuperate. Therefore, people who receive sedatives are not conscious, their eyes are closed, and they are often immobile. Hence, they cannot see what happens around them or move unless the sedation has been lowered or stopped. However, the fact that they cannot see their surroundings does not mean they cannot hear what goes on around them.
Words are powerful
As of today, there is evidence that people can still hear noise and voices while in a coma. Some of them may remember an entire conversation people around them had. That’s why it is important that we give them the feeling that they are not alone.
First I did not believe this could be possible when I joined the team. But then I looked after a lady in Intensive Care during Christmas. And when it was safe to stop her sedation and wake her up, she really surprised me. Her first question after she regained consciousness was, “Why did you stop singing?”
I could not hide my smile, thinking I had been singing Christmas Carols as part of a music therapy technique widely used in the unit.
Why does this happen?
Being able to hear while being sedated can have a positive side, such as hearing familiar voices and reassurances from the staff. But it can also have a negative effect. Who would be happy to hear voices and be unable to connect to them or answer back? This inability to find a connection with the person who is talking may increase frustration. And it may contribute to the development of PTSD whilst they are recovering.
Books tell us that PTSD usually happens following stressful, distressing and frightening events. You may now think, what is so stressful whilst sedated in Intensive Care and most of the time, you can’t remember what happened when you wake up?
Imagine for a second, that you are not feeling well and call an ambulance or pass out. And that this is the last memory you have before being woken up by a voice asking you to open your eyes. When you wake up, you see an unfamiliar face, a tube coming from your mouth and one or two from your nose, attachments everywhere. Then you hear the beeps coming from the machines that have helped you get through the illness. You suddenly realise that what you thought was your dream is actually real, and the noise seems incredibly loud.
Would you feel distressed and frightened? Personally, I would. Mainly because, just like all human beings, I am used to having control over my body, my actions, my gestures. Being in a coma, the power of control gets taken away. And people may experience a loss of identity and loneliness.
People often feel frightened and alone
“Who am I? Where am I? Who are those people around me? And why do they keep saying that they are nurses and doctors, surely I am not in hospital. But why am I on a boat, and why have my relatives left me here?” *
That’s what I usually hear after people wake up from a coma.
To add further, sedative drugs, despite being very good in terms of reducing awareness of painful and uncomfortable procedures, may have some side effects, just like other medicines. Critical illness and administration of sedatives may contribute to the onset of nightmares and hallucinations. These can be very vivid, and people often struggle to discern them from reality.
I have often heard people seeing fire in the surroundings, thinking of being on a floating boat, feeling frightened by medical staff as those resemble mythological figures rather than human beings. For some of those, there is an explanation. For example, the feeling of being on a floating boat could be due to the hospital mattress cells that inflate and deflate alternatively to prevent skin damage. However, they may as well be because of how the brain has processed information during critical illness.
Nightmares, hallucinations, loss of identity, disorientation, sleep deprivation may be contributing factors to the development of delirium post-critical illness. If you now consider all the factors, you may understand where PTSD generates from after being critically unwell.
I hope my description has not bored you much. But it was necessary to make you fully understand what I do and how I support people with PTSD.
Active listening is the main secret
This world is continuously rushing, and people do not have time to talk between them. Some may ask how you feel today, but they may not pay much attention to your answer. For those affected by PTSD, often talking and feeling that they are listened to are essential.
I am not a therapist. But when I come across people who are developing PTSD following critical illness, I absolutely love creating a safe space where they can express their feelings and their emotions. Empathy and putting ourselves in their shoes are critical. And so, I respect their opinion and do not judge them. I keep their information confidential and escalate my concerns when needed. I do my best to give them the feeling that they are not alone.
In many situations, when I realise that a therapy delivered by a specialist is needed, I can refer people to talking therapies and cognitive behavioural therapy. I can also help create a link with a support group. But there is one thing that I am really proud of in regard to my team and all the teams that deliver the same service. We provide good quality time to people and do not look at the clock.
You are not alone
PTSD may make people feel sad, angry, overwhelmed, lonely. Most of the time people tend to isolate themselves because they do not feel listened to or understood. So, let me tell you this, “If you are battling PTSD, I want you to know that YOU ARE NOT ALONE.“
There is a lot of support out there, and those who have gone or are going through the same feeling. All you need to do is shout for help. Do not feel ashamed or afraid of holding the hand of others. No one should feel alone.
It may surprise you to read this at this place, but I suffered from PTSD when I was younger. This was due to my dad being physically and emotionally violent towards my mother. But this is another story. And I am now many chapters ahead of it, so revisiting it won’t benefit either of us. I have healed, and I want to offer you to hold my hands so you can heal too. You don’t need to feel alone. And as someone said, “Healing does not mean that the damage never existed, it means that the damage no longer controls our lives”.
*During the first visit after discharge from Critical Care, people often describe these feelings as the first impact of reality as soon as they wake up.
Valentine, or Val as she is known as well, is a critical care nurse from Italy who moved to England to follow her dreams. She currently works in the Intensive Care Unit, and despite the challenges and some hard times, she loves her job. Travelling is her passion, but she prefers nature to cities. She believes in positive psychology and in the energy of the universe.
Read more real-life stories from trauma survivors here: ‘PTSD: My Story Project‘.
Do you have experience with PTSD, or do you take care of / live with someone who has? Would you like to share your story in a guest blog post?
I’m not an expert or a health professional, so the aim of this project isn’t to offer professional advice. Neither is it to pity those who experience PTSD. That’s not what I want. My aim is to raise awareness of PTSD. By sharing your story, you can inspire and empower others. You can highlight the methods that helped you. This way, you can encourage others to reach out for help.
And it may help you as well. Perhaps it’s something you feel like you’re not able to talk about within your closest circle and would like to connect with others in a similar situation. It’s nothing more than bearing an untold story inside you. The fact is that our society still lacks an understanding of mental health. Therefore, I’ve decided to share my story and invite others to join me in this project and write a blog post about their experience. By working together, we can help destigmatise mental health problems and promote well-being.
To be featured
If you would like to join in and share your story on my blog but don’t have the experience of writing a blog post, this isn’t a problem. You can still contact me, and I’d be happy to assist you with the writing. And you can use a pseudonym if you wish to stay anonymous. You can share as much of your story as you want in a way you feel comfortable with.
The only thing I ask is that you mention ‘PTSD: My story project’ in your post and briefly state why you have chosen to take part in it. You will be allowed to approve the post before publishing it, should it be edited.Follow Journeyofsmiley on WordPress.com