Causes, assessment and management of fatigue in critically ill patients

Fatigue is a common complaint among hospitalised patients and is one of the most prevalent and distressing symptoms reported by critically ill patients in the intensive care unit (ICU). Fatigue comes in many forms, is associated with a wide range of aetiologies, and is aggravated and intensified by a multitude of environmental and situational factors present in the intensive care environment. While assessing and evaluating fatigue is key to the effective management of this distressing symptom, reports have shown that fatigue assessment in the ICU is suboptimal and patients are often left suffering from its untoward consequences. Furthermore, the experience of fatigue that originates in the initial ICU admission often persists months to years after being discharged, and this has been shown to be associated with worse patient outcomes. Nurses are in an ideal position to identify, diagnose and evaluate patients who may be at risk of experiencing fatigue and put in place interventions as necessary. This article aims to discuss the incidence, causes, and clinical implications of fatigue among ICU patients and discuss ways in which nurses can effectively assess, diagnose, evaluate, manage and treat patient's fatigue within the ICU environment.