Good care, concern, and professionalism characterize the staff of the intensive care unit at the Luis Aldana Palomino General Teaching Polyclinic with hospitalization services in the municipality of “Amancio,” the only one of its kind in the south of the province.

This is confirmed by the mother of Yurianni Sánchez Írsula, a “girl” from El Indio, a rural community in the southern town, who, although she is 28 years old, needs special care because she is a special person with severe Down syndrome that prevents her from caring for herself.

Yurianni has congenital heart disease and arrived at this service with community-acquired pneumonia, which kept the entire staff of the health care center on alert because, due to her cognitive characteristics, she receives extra doses of care.

ICU: CARE, ATTENTION, STRESS

“To be admitted to intensive care, a patient must be in a serious, life-threatening condition, with one of their vital signs—blood pressure, pulse, heart rate, or respiratory rate—unstable. Any of these indicators is grounds for admission,” said Lisandry Rodríguez Labrada, head of this service, speaking to 26.

The conditions are in place to receive pregnant women, postpartum women, children, and adults in serious condition, as well as patients with different pathologies, as they have five beds, four of them in a multipurpose cubicle and one isolated.

In addition, they have professionals ranging from doctors specializing in intensive care and emergencies, clinicians specializing in internal medicine, and 17 nurses, all certified and specialized in intensive care in the municipality.

Rodríguez Labrada explains that one of the catalysts for working in this area is sensitivity. "That is a particular feature of this service because here the nurse must fulfill their duties and the role of companion, offering water, food, hygiene, and all kinds of care. This is unlike other wards, where patients have at least one family member with them.

“We avoid referrals to the Provincial Hospital because the family suffers from the distance, and if necessary, they follow a protocol. When the patient requires other care that is beyond the assistance we provide in the municipality, for example, some tests or CT scans, then we refer them.”

One of the most complex issues faced by the professionals who work in this ward is privacy. They have received patients of all ages and seek ways to protect the privacy of each one so that no one feels disrespected.

“We have had young people operated on with older adults who sometimes do not let them sleep because they miss their families, their comfort zone has changed, and they complain and cry, but the others understand and cope with it.”

What are the most common medical criteria for deciding on admission?

Lisandry argues that "Admission to the ward has its pathologies; we are assuming cerebrovascular diseases, transient ischemic attacks...

"Admissions are assumed for hypertensive emergencies, heart attacks, cerebrovascular disease, and uncontrolled diabetes. But one admission that causes us a lot of stress is heart attacks, especially because they occur in relatively young people, between 40 and 50 years old.

“These cases are treated with medications that sometimes cause symptoms, although they improve quality of life. When we administer them, it causes a lot of stress and puts the whole team on alert. When we repeat the electrocardiogram, the pain subsides, we see an improvement in vital signs, and that's when we feel the result of so much stress.”

FROM THE MUNICIPALITY TO THE PROVINCE, A HUGE DIFFERENCE?

There are obvious differences between an intensive care unit at the Provincial Hospital and one in a municipality. The head of the service explains that at “Guevara,” when a seriously ill mother is admitted, she is cared for from the moment she arrives until she is discharged, while in the municipal ward, she is cared for some time.

"They surpass us in terms of pathologies, and they have more stories to tell because they receive multiple trauma cases, which we don't see much of here.

“We almost always have patients in the ward. We might go a day or two without admitting anyone, but we are ready for any medical situation that may arise.”

For Lisandry, calm is synonymous with a storm. It is paradoxical, but she does not like the absence of patients in her area. “I prefer the adrenaline of work. Although it is good that there are no people admitted.”

The intensive care unit at “Amancio” represents a guarantee of the health system in this municipality, because it not only receives patients from this locality but also from "Colombia" because of its distance from the “Guevara” Hospital.