Helping Patients with Endotracheal and Tracheostomy Tubes Communicate

CAROLYN A. LAWLESS, R.N., was team leader, respiratory intensive care unit, Massachusetts General Hospital, Bogton, when this article was written. She is now an instructor at the Massachusetts General School of Nursing. the essence of man's inner life, even as they belong to his life in society(1). If this is so, it is not surprising that patients in an intensive care setting often lose touch with reality, resort to manipulative behavior, become aggressive, or withdraw. ICU psychosis is an extreme example of a confused mental state induced by feelings of isolation and fragmentation of being. True, not all patients reach this extreme state, but there are sufficient data to support the fact that patients vary in their reaction to the confinement experienced in an ICU and that these reactions are not