A person in intensive care seems to fall out of our world. You can’t come to him, you can’t talk to him, they take away his phone, clothes and personal belongings. The most that loved ones can count on is a note sent through a nurse. What if it's a person? What if it's a child? All you can do is wait for a call from the doctor and hope for the best.

Why are there such draconian rules in hospitals and how not to go crazy from the unknown? We answer the most frequently asked questions about resuscitation.

1. Will he die?

Don't stress yourself out and don't panic. Yes, your loved one has health problems. Yes, this is serious. And yet, if someone is in intensive care, this does not mean that he is on the verge of death. A person can be put there even for a couple of hours - for example, after. As soon as doctors are convinced that his life is not in danger, the patient will be transferred to a hospital.

The prognosis depends on the severity of the patient’s condition, age and concomitant diseases, from doctors, from the clinic and many, many other factors. And, of course, from luck.

2. What's going on there?

Doctors need access to equipment, and nurses need to be able to wash the patient - that’s why they usually lie naked in the department. Many people find this inconvenient and humiliating.

Maria Borisova told the story of her elderly mother on Facebook: “They immediately said: “Undress naked, take off everything, socks and panties inclusive.” Mom was lying in a large corridor, where a huge number of people were walking, talking loudly, laughing. A small detail: in order to relieve yourself, you must get up naked from your bed in front of a large number people who walk back and forth, sit on the vessel on a stool that stands next to the bed, and defecate in public.”

Lying under one sheet can be not only embarrassing, but also cold. And dangerous for already weakened health. There are diapers and disposable underwear, but these are additional costs. And the money in public hospitals There's always not enough. Therefore, it is easier to keep patients naked. If a person is able to walk, he may be given a shirt.

Bedridden patients are treated daily with liquid to prevent bedsores, and are turned over every two hours. The body is also kept clean. Hair and nails are cut. If the patient is conscious, he can do this himself.

Life support systems and tracking devices are connected to the patient in intensive care. They can also tie him to the bed so that in his delirium he does not pull out all the sensors and harm himself.

3. Why am I not allowed to see him?

By law, doctors cannot refuse to admit you to intensive care without a serious reason. If a child under 15 years of age is admitted there, the parents have the right to go to the hospital with him. But this is in official papers, but in practice everything is different. Hospital staff have a “classic” set of reasons for not letting relatives in: special sanitary conditions, infections, lack of space, inappropriate behavior.

Whether this is right or wrong is a complex question. On the one hand, in the West you can visit a patient almost immediately after surgery. This gives peace of mind to both the relatives and the patient. On the other hand, in the West the conditions are suitable for this: air purification systems, bacterial filters, spacious rooms. And who can guarantee that he won’t faint when he sees a loved one unconscious and covered in equipment? Or won’t he rush to pull out IVs and tubes? This is also not uncommon.

In general, whether you insist on visiting or not is up to you. If the staff flatly refuses to let you in, refer to federal law No. 323 and contact the clinic management.

Follow all visiting rules: wear a robe, mask and shoe covers. Tie up your hair and bring hand sanitizer.

4. How can I help?

You can buy missing medicines, care products (“duck”, for example), or special food. You can hire a caregiver or pay for an outside consultation. Ask your doctor if this is necessary.

And ask the patient himself if he needs anything. Children often ask to bring their favorite toys, adults - a tablet or books, elderly - even a TV.

5. How to behave in intensive care?

As calm as possible. Don't disturb the staff. Your loved one may be unconscious or acting strangely. It may look or smell unusual. Tubes and wires may be sticking out of him, and wounded, seriously ill people may be lying in the same room with him. Be prepared for anything.

The patient largely depends on his mood, and the mood depends on you - your loved ones. Don't cry, don't get hysterical, don't wring your hands and don't curse fate. Talk to him as if he were healthy. Don't discuss the illness until he brings it up. It’s better to discuss the most ordinary, everyday things: how things are at home, what news your friends have, what’s happening in the world.

If a person is in a coma, you also need to communicate with him. Many patients actually hear and understand everything that is happening, so they also need to be supported, stroked on the arm and told latest news. Research shows it speeds up recovery.

If a patient asks to meet with a priest, doctors are required to let him into the room. This right is ensured by Article 19 of the bill “On the fundamentals of protecting the health of citizens in the Russian Federation”.

The intensive care unit is one of the most mysterious departments in the hospital. You can drive through the whole city and end up in front of closed door, and even if you insist, they will not let you into the department. “The condition is stable. You can't go inside. We provide all the care ourselves. Goodbye". All. What's going on behind that door? Why might they not let you into the department, although they are obliged to? Here are some reasons (and life situations).

The patient has just arrived

The patient was admitted by ambulance, surrounded by two doctors, three nurses, and a nurse. You need to transfer him from the gurney to the bed, connect pulse, pressure, and saturation sensors. Arrange venous access, collect blood and urine for analysis. Someone collects IVs and prepares drugs for administration. Someone assists the doctor - tracheal intubation is performed because the patient cannot breathe on his own.

At this time the doorbell rings. The intensive care workers have the keys, which means this is a relative. It’s impossible to let him in now, the doctor can’t talk to him, because helping the patient is more important. But relatives may insist on a visit, besides, they immediately want to know the diagnosis, receive information about the condition and “how long he will lie here,” although the person, let me remind you, has just been delivered and nothing is really known yet.

New patients arrived

This is the most common reason. The fact is that intensive care is not just a department. There is no strict visiting schedule. Or rather, he is. But if in the interval, say, from twelve to one, when it is allowed to visit patients, a seriously ill patient is admitted, no one, alas, will allow you to enter the ward. During patient admission, manipulations, etc., outsiders are prohibited from being present in the room.

Other patients in the ward

Yes, you need to remember that in addition to your loved one, there may be other patients in the ward. Lie down as you should in intensive care, without clothes. And not everyone will be pleased if people walk past them strangers. In the USA - this country is often cited as an example when talking about organizing visits to intensive care units - there are separate rooms for patients, and there are even sleeping places for relatives. This is not the case in Russia - several people are in one room.

A patient is recovering from a planned operation

Moreover, some patients, being in an unpresentable state, do not even want to see their relatives. For example, after elective surgery The patient spends the first day in intensive care. Lying naked. His throat is sore after the tube artificial ventilation. My stomach hurts. The bed is stained with blood because the bandage is leaking a little. He is in pain, but now they have given him an injection and he is falling asleep. In two days he will be transferred to general department, soon he will cheerfully run along the corridor and discuss his health with his family, but now he only wants to sleep. And he doesn’t need any visits.

The patient’s relative is not ready to visit

Another situation. The man lies for a long time. The diagnosis is serious. A relative arrives and really wants to see you. They let him through. After talking, the relative leaves the room into the corridor, goes to the door, but before reaching it, he faints right into the arms of the nurse on duty. It’s good if he is not very tall and large, and there is a trestle bed nearby on which they can lay him down...

Unusual people are scared foreign objects sticking out of the patient: catheters, probes, drainages. The departments often smell bad and can make any visitor feel sick. Moreover, if doctors see a relative in a clearly unbalanced state - such high probability visitation may be denied.

If not objective reasons, preventing the visit, the relative will be allowed into the ward. Sometimes relatives help a lot - wash, treat, rearrange. This is real and necessary help because there is always not enough staff. They are always allowed to see patients. And such people always wait patiently outside the door if manipulation is being carried out in the hall and outsiders are not allowed to enter.

You need to be prepared to visit the intensive care unit. Do not be frightened by the sight of your relative or his roommates. Don't wrinkle your nose at unpleasant odor. Do not cry with pity - this can be done behind the door, but here, next to the patient, you should support him, not he you. Do not disturb the staff and leave the room upon request. If you are not allowed in, it is best to wait quietly outside the door until the doctor is free and you can ask him all the questions that interest you. Reanimation is a department emergency assistance, and in emergency situations there is not always time to talk.

Anastasia Larina

Photo istockphoto.com

Medical staff working in the intensive care unit are seriously concerned about the possibility of various complications after surgery caused by infection. Each medical institution is trying to solve the issue of the emergence and spread of nosocomial (nasocomial) infections, making every effort to avoid this. Responsibility for postoperative complications lie with the employees of this institution. To reduce this likelihood, most hospitals have strictly prohibited family visits from people in the intensive care unit recovering from major surgery.

In a number of hospitals for children, such a ban has even been introduced for patients to be visited by their own parents. This is a violation of the child's right to non-separation from his mother. Guided by considerations for the safety of a sick child, doctors and medical staff They have been violating the Russian Constitution and a whole list of laws for many years.

By doing this in relation to adult patients, they violate only the first paragraph of Article 6 of Law No. 323-FZ “On the Protection of Citizens’ Health.” It points out the requirement of ethical, respectful and humane behavior on the part of hospital workers. And the article also says that during construction medical institution, the premises in it must be designed in such a way as to comply not only with hygienic standards, but also to ensure the comfort of patients. It also states that “the priority of the patient’s interests can be realized by creating conditions that provide the opportunity for relatives to visit the patient and care for him in a medical facility, taking into account the patient’s condition.”

But in reality, hospital staff may not allow loved ones into the intensive care unit even to say goodbye to the dying person. Doctors refer to Article 27 of the above law, which states the need to comply with the internal regulations of the hospital. Thus, permission to let in or not let in relatives is given exclusively by the administration of the hospital institution. In accordance with this, in many, but not all, intensive care units, the entry of close people to patients is strictly prohibited.

For a long time there were no serious objections to the established practice. This meant that thousands of people could not exercise their right to be with a dying person.

According to one of the experts, a lawyer for medical problems: “In accordance with current legislation, relatives are right. If you are denied access to a patient, you must first obtain a written refusal from the head of the hospital's medical department, and then contact the prosecutor's office with it. In this case, the administration’s references to Art. 27 FZ-323 are unfounded, since the care of a relative for a patient does not in any way violate the internal regulations of the hospital, only specific inadequate citizens can violate them - they should be denied access, this will be legal.”

The Russian Ministry of Health confirmed the right of loved ones to visit the sick

On March 14, the media reported that “the ban on visiting children is a direct violation of Federal Law No. 323. And the ban on visiting adults in the hospital violates the provisions of the Constitution on freedom of movement.” In this regard, both the Prosecutor's Office of the Russian Federation and Roszdravnadzor had the opportunity to call for the elimination of this law-breaking practice, and people who personally encountered such a ban have the right to challenge it in court.

But even despite these laws allowing loved ones to be in intensive care, many medical workers they did not allow this, citing the following reasons: firstly, due to the danger of viruses; secondly, because of fears about the possible abnormal reaction of loved ones.

The current situation became so serious that in March of this year, the website Change dot org began collecting signatures for an appeal to the Russian Ministry of Health.

The result of this struggle was that the Ministry of Health recognized the right of relatives to visit people in intensive care units of medical institutions.

Oleg Salagay, head of department public health and communications of the Ministry of Health stated: “Every patient, including those in intensive care, has the right to be visited by his relatives. A letter with a recommendation to ensure the implementation of this legislative norm was sent by the Ministry of Health to all regions back in 2015.”

Salagay emphasized: “if there are violations, you need to contact the insurers who issued the policy to you, as well as the regional health authorities and control authorities.”

“As for adult patients, the legislation has established the right to visit relatives while they are in hospital. medical organizations, and for children - visiting and staying with relatives for the entire duration of treatment, including being in the anesthesiology-reanimation department,” Salagai said.

State Duma deputy Nikolai Gerasimenko submitted to parliament a bill that would allow relatives and legal representatives visit patients in intensive care units. Today, the law allows people to visit sick relatives, but the decision on this is made by the management of the medical institution. There is no direct reference in current legal documents to the fact that hospitals are obliged to provide the opportunity to visit patients in intensive care in any situation, even if the doctor did not give such permission.

In May 2016, the Ministry of Health published a letter with recommendations and conditions under which relatives can enter the patient’s room. According to these rules,

when visiting intensive care units, relatives should not have signs of acute infectious diseases (elevated temperature, manifestations respiratory infection, diarrhea). In addition, before visiting, medical staff should conduct a brief conversation with relatives and psychologically prepare them for what they will see in the department.

Also before visiting the ward close person the patient must be removed outerwear, put on shoe covers, a robe, a mask, a cap and wash your hands thoroughly.

However, this document still transfers the final decision on the admission of a relative to the authority of the management of the medical institution. Gerasimenko notes that today access to patients in most cases is a gesture of goodwill by the chief physician. This, in his opinion, causes a negative reaction in society and reduces the effectiveness of treatment. IN explanatory note to the bill, the parliamentarian referred to the experience of many foreign countries, where relatives and representatives of the patient can freely stay with him in the intensive care unit.

The State Duma deputy also noted that, according to the Russian Ministry of Health, access for relatives to patients in intensive care units is not organized in all medical organizations. “For example, in the Primorsky Territory, patient access is provided in only 10 out of 27 children’s intensive care units,” says Gerasimenko. But parents’ access to small patients in intensive care is one of the priorities in domestic clinics.

Let us recall that in February 2014, Russians began to complain that in most medical institutions parents are not always allowed to see their children in the intensive care unit, explaining this by the fact that they could harm the child. The Vera Foundation sent a letter to the president, in which he spoke about the tragedy of those mothers who are forced to wait at the doors of the intensive care unit until they are allowed in to see their child for at least five minutes. Later, the Ministry of Health reported that Russian legislation does not prohibit parents from being near their child in the intensive care ward. The department required hospitals to accept necessary measures on organizing visits by relatives of children in anesthesiology and intensive care units.

The medical community is divided on whether the patient's relatives should be allowed into the intensive care unit.

Some doctors believe that every intensive care patient would like to have the opportunity to see their loved ones, and relatives are afraid not so much of what exactly happened to their loved one, but of the unknown.

Once outside the doors of the intensive care unit, they will be convinced that the doctors are doing everything necessary. Other health workers say that not all relatives can adequately perceive the condition of their loved one and the ban on visiting the intensive care unit thereby protects them from shock.

Director of the Institute of Health Care of the National Research University Higher School of Economics Larisa Popovich is sure that it is impossible to oblige relatives to be admitted to intensive care, no matter what. “I believe that this cannot be an obligation, because only doctors can really determine how safe it will be for relatives to visit the intensive care unit,” she told Gazeta.Ru.

Popovich added that in Russia there are more stringent requirements for the sanitary and epidemiological regime in hospitals than in many other countries. “If very powerful antibiotics, then we still prefer to maintain sterility. Therefore, the possibility of visiting the rehabilitation department is determined only on the basis of the current conditions of sanitary and epidemiological support in the hospital and the patient’s condition,” the expert noted.

Larisa Popovich emphasized that this kind of thing very much depends on national characteristics organization of the health care system. "Let's say

The absence in Russia of a disinfection system at the entrance to a hospital significantly limits the possibility of admitting relatives to the hospital in principle. In Israel, for example, you can even enter the operating room from the street in ordinary clothes.

I myself observed how, during a neurosurgical operation, a man stood in a jacket and spoke on the phone. But they have a very serious antibiotic therapy system. Why do you and I need this? “Everyone has their own technology for dealing with post-operative complications,” she said.

When asked by Gazeta.Ru whether the infrastructure in Russian hospitals is sufficiently developed for relatives to stay in the intensive care unit for a long time, Popovich replied that no one is going to set up hotel wards in the intensive care unit. " It's about about short-term visits and psychological support, which does not require being in the ward all the time. In the USA, relatives are also kicked out if certain situations arise - they are far from long period are in the wards,” noted the director of the Institute of Health Care at the National Research University Higher School of Economics.

Lawyer of the Society for the Defense of Patients' Rights Anna Oreshkova agreed with the argumentation of the author of the bill. “Relatives should be allowed into intensive care because it benefits everyone. However, in such a specialized department there are no conditions for organizing the flow of relatives: there is serious equipment and patients are in critical conditions. Under this law, certain conditions need to be worked out,” the lawyer told Gazeta.Ru.

Good morning my name is Evgenia enia . This year I spent more than 3 months in the hospital, more than 2 weeks of which were in intensive care.

So... Reanimation. Or in other words “intensive care unit”. Those who actually need " intensive care", not available in the regular branch.

There are completely different ones available medicines, equipment and unlimited access to the laboratory (for analyses) and personnel.

There's a completely different world there. Everything is much cleaner, stricter, tougher... and more serious. They don’t lie there with simple diagnoses or for examination because “something stabbed in the side.” If you are in intensive care, it means there is a threat to life and everything is very serious.

But first things first.

They bring you to the intensive care unit naked. At all. Wedding ring And pectoral cross will also need to be removed. You cannot take anything with you... Phones, books or any other entertainment - all this remains in the department. The sister will carefully collect your things in a large bag, and put special valuables in the safe. But this is already without you. If they told you that they are transferring to intensive care, then they will take you without delay... with a breeze. The maximum you can do is undress.

Upon entering the intensive care unit, you will immediately be surrounded by wires. The kit includes installation of a subclavian catheter (for conventional droppers), often with a tee, so that several jars can drip at once, spinal anesthesia(infusions into the spine) for pain relief and more, sensors on the chest to determine heart rate (I don’t remember what they are called), a cuff on the arm (for measuring pressure) and urinary catheter(to a heap... because, of course, there is no question of getting up and going to the toilet in such a set of wires). And this is just the “basic package”. In the case of more serious or simply specific problems, there are another two dozen different devices that can be connected to you.

Devices are a quiet horror of intensive care!!! They squeak all the time! Quietly, but confidently, constantly. In different tones and modes. With different tempo-rhythm and volume. Someone is telling someone off heart rate, someone signals about the pressure, someone simply sings some song unknown to me without shutting up... And so 24 hours a day! And if one beeper is turned off, it means another one will be connected soon! This constant soundtrack literally drives you crazy.

The rooms in our department were for four people. Men and women, old, young, heavy and not so heavy - all together.

- There is no room for embarrassment here.- they told me for the first time. And I remembered it.

There is a nurse in each ward. She is indoors almost constantly. And she is always busy with something. She doesn't sit still for a minute. He either changes someone’s IVs, or takes some tests, or fills out some documents, or straightens the beds, or turns around the attendants so that they don’t develop bedsores. Every morning, all patients must be washed with special hygiene products and change the bed.

The staff in the intensive care unit is specific... These people, both doctors and nurses, seem tough and even almost heartless. They talk in official numbers and diagnoses, and the dialogue is conducted in the style of “twice two makes four.” At first, such a lack of humanity was depressing, but then I realized that it was just a mask... Once I burst into tears, even the manager came to calm me down. Department. Simply human... All their callousness is nothing more than defensive reaction so as not to go crazy in this horror.

The worst thing in intensive care is the patients! Someone is moaning, someone is screaming, someone is delirious, someone is vomiting, someone is wheezing, someone is getting an enema, and someone is just quietly dying on the next bed. You fall asleep to the quiet moans of your neighbor's grandmother, and when you open your eyes, she is already being taken away, covered with a sheet... and this happens all the time, around you, in close proximity. And this is very scary...

Every new patient causes a big commotion. Doctors flock to him from all over the department, entangle him with IV wires, make different procedures. For some, a capillary in the nose, for others, gastric lavage, and for others, intubation. All this is nearby, here, with you... All this is in a hurry, because minutes are counting, because another patient was brought in next and he also needs to be saved, now, at this minute... and there is no way to press pause! And all this at any time of the day or night... With bright lighting and musical accompaniment dozens of devices beeping in different ways...

And visitors are not allowed into the intensive care unit. And you lie in a complete information vacuum, entangled in wires, with a wild headache (despite all the painkillers) from beeping devices, surrounded by moaning and delirious people, and counting the minutes until you will be released from this hell...

But when you see how the person in the bed opposite, who just yesterday was unable to breathe on his own, has the tube removed from his throat, and the next day he is transferred to a regular ward, you understand what all this is for...

They really do everything to save lives... Although without unnecessary curtsies.

This year I was in intensive care 6 times! But even 1 time is too much!!!

Never go there.

If you have questions, please ask them in the comments!