Delirium Revolution

Julie Highfield

Consultant Clinical Psychologist ,

Dr Julie Highfield is a Consultant Clinical Psychologist & Lead for Organisational Health in Adult and Paediatric Critical Care, Cardiff. She is the National Project Director for Wellbeing in the Intensive Care Society. She has a long experience of working as a psychologist in medical and health care settings and works closely with staff in their experience of working in healthcare, as well as advising managers on matters of workforce wellbeing. Julie has worked with the British Psychological Society and its Division of Clinical Psychology in Wales. She led the BPS team writing the National Guidance for Staff in the Coronavirus Pandemic.

Julie works with the Welsh Assembly Government in various projects, including as the lead for Critical Care Workforce Task and Finish Group, and Modelling for Rehabilitation for patients post COVID-19, and the Wellbeing Conversation Tool. She has a number of publications and book chapters in the field of critical care, staff wellbeing, and leadership.

 

: @DrJulie_H

Louise Gallie

Patient Advocate,

From November 2018 through to January 2019 I was critically ill. I experienced the NHS at it’s finest and was cared for by the most fantastic team of nurses, healthcare assistants, consultants, surgeons, physiotherapists, occupational therapists, dieticians, cleaners, the list is endless.

Quite simply, I owe them my life…….

In 2018, after 3 years of struggling, I was diagnosed with a rare condition called Achalasia. In simple terms, this is where the oesophagus doesn’t work properly making it difficult for food or liquid to pass from the mouth to the stomach. There is no cure for Achalasia, it’s a progressive disease and there are only palliative options.

I was offered a complex procedure called a ‘Heller Myotomy’. A cut was to be made at the lower sphincter of my oesophagus allowing solids and liquids to flow freely into the stomach. To prevent reflux, I was also to have a fundoplication or ‘wrap’ from the stomach to the oesophagus.  It was not a cure but instead offered a means of relieving the symptoms.

On 21st November 2018 I went in for surgery. The procedure went well but my oesophagus ruptured during surgery. Having gone undetected during my post-operative recovery, I suddenly took a rapid, dangerous descent downhill. All that I had drunk in the 24/36hrs following surgery, along with other fluids, had been filling my abdominal cavity. I was critically ill and my body was experiencing one of the most severe types of trauma possible. During emergency surgery my abdominal cavity was flushed with 10 litres of fluid. I had early onset sepsis, my left lung collapsed, my kidneys began to fail, I went into shock and multiple drains, tubes and lines were inserted.

I found myself on the Intensive Care Unit at University Hospitals Plymouth (Derriford), waking from a medically induced coma. Then began a very slow, painful recovery waiting for my oesophagus to heal naturally, whilst being nil by mouth for the entire time. My world along with that of my family, had been turned upside down. 84 days in hospital from ICU to the ward was without doubt, the toughest battle I’ve ever had to fight.

During my time in ICU I experienced severe deliriums: Vicious, vivid nightmares, visions and hallucinations, thought to be brought on by infection and medication.

I’ve created my blog https://fromdeliriumtoreality.com/  to support my recovery. I now have a new best friend, PTSD! I have been very fortunate to receive rehabilitation and psychological support from the ICU rehab team – without them I’m not sure where I’d be. Me and PTSD walk hand in hand through life, reminding me of what I’ve been through but also reminding me how very lucky I am.

This blog allows me to process my thoughts whilst sharing my own personal experiences of life as an ICU patient and beyond.

: www.fromdeliriumtoreality.com
: @RehabLegendLou

Wes Ely

Critical Care Physician, Internist and Pulmonologist,

E. Wesley Ely, MD, MPH, is an internist, pulmonologist, and critical care physician. Dr. Ely earned his MD at Tulane University School of Medicine, in conjunction with a Master’s in Public Health. He serves as the Grant W. Liddle endowed chair in medicine and is a physician-scientist and tenured Professor at Vanderbilt University Medical Center. He is also the Associate Director of aging research for the Tennessee Valley Veteran’s Affairs Geriatric Research Education Clinical Center (GRECC) in Nashville TN. He is the founder and codirector of the Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center, and a pioneer in the investigation of delirium and long-term cognitive outcomes, including dementia, in survivors of critical illness. Dr. Ely is the author of Every Deep-Drawn Breath, from which he’s donating 100% net proceeds to help COVID survivors and family members rebuild their lives.  

Kate Tantam

Specialist Intensive Care Sister, UK

Kate is a Specialist Sister in ICU in Plymouth.  Her role is to support patients, loved ones and staff pre and post ICU discharge.  She is a nurse researcher in rehabilitation after critical illness and the founder of the #Rehablegend campaign. The campaign shares patient stories to share best practice, improve patient experience, support quality improvement and clinical research and raise awareness of the importance of rehabilitation for all.  Her work was recognised with a Parliamentary Award for care and compassion in 2019, National Patient Experience Award in 2019.  Her work during 2020/2021 supporting patients with COVID saw her awarded with a British Empire Medal for services to improve patient experience.  She is the deputy chair of the National Rehabilitation Collaborative and is keen to develop national work to support recovery after ICU.

: @tantamkate

Andy Bates

Critical Care Research manager/Doctoral Research Fellow,

Andrew Bates is an NIHR funded Clinical Doctoral Research Fellow at the University of Southampton.

His doctoral thesis involves investigating the use of trauma-focussed psychological therapy to improve the mental health recovery of critical care survivors.

His mixed methods approach includes in-depth interviews with patients experiencing symptoms of traumatic stress, which has drawn him to explore the underlying causes.

Helped by an expert supervisory team, Andrew is also investigating whether our patient’s ongoing traumatic stress may, in part, have biological origins, starting in the ICU.

Catherine McKenzie

Consultant Pharmacist,

Cathy McKenzie is Consultant Pharmacist and Honorary Associate Professor in the Faculty of Medicine, University of Southampton.

Her research interests are safe and effective drug use in critical illness.

Cathy is especially interested in researching interventions that will minimise delirium in the Intensive Care Unit (ICU) to reduce distress it causes patients, family members and healthcare professionals caring for them and to support patients in living a good quality of life after ICU.

She has a number of publications and  research funding awards.

Cathy is also editor in chief for Critical Illness (CI),(www.medicinescomplete.com), an e-book published by the Pharmaceutical Press.

 

Michael Rosen

Poet, Performer, Broadcaster, Scriptwriter and Former ICU Patient,

Michael Rosen is one of Britain’s best loved writers and performance poets for children and adults.

His first degree was from Wadham College, Oxford and he went on to study for an MA and a PhD. 

He is currently Professor of Children’s Literature at Goldsmiths, University of London where he co-devised and teaches an MA in Children’s Literature.   

 Michael is also a popular broadcaster and has presented BBC Radio 4’s acclaimed programme about language, “Word of Mouth” since 1998, as well as regularly presenting documentary programmes for BBC Radio 4 and BBC Radio 3, including the Sony Gold Award-winning “On Saying Goodbye”.   

Michael has published in the region of 200 books for children and adults, including “The Sad Book” with Quentin Blake (Walker Books) - a meditation on bereavement written after the loss of his son, Eddie;  “We’re Going on a Bear Hunt” with Helen Oxenbury  (Walker Books) - made into an animated film for Channel 4 broadcast Christmas Day 2016 -  and “A Great Big Cuddle” with Chris Riddell (Walker Books) .  

His poetry for adults includes “Don’t Mention the Children” (Smokestack) and “Selected Poems” (Penguin).  Non-fiction work for adults includes “Good Ideas: How to Be Your Child’s (and Your Own) Best Teacher” (John Murray),  “The Disappearance of Emile Zola, Love, Literature and the Dreyfus Case” (Faber), and his memoir “So They Call You Pisher!” (Verso).   

He has written a book for children and teachers on writing poetry ‘What is Poetry?’ (Walker Books) and has done three booklets for teachers on writing and reading. These are available through his website www.michaelrosen.co.uk . He writes up a monthly news page on the website and a blog for teachers giving ideas for writing.

Michael writes a monthly open “letter” to the Secretary of State for Education in The Guardian where he critiques Government policy on schools from the standpoint of a parent.  He visits schools, teachers’ conferences and university teacher training departments where he is in demand to give performances, workshops and keynote addresses. He also appears regularly at literary festivals all over the UK and Ireland.  

Michael has received several honorary awards, including degrees from the Open University, the University of Exeter, the University of London Institute of Education and the University of East London/Tavistock and Portman NHS Trust.  For outstanding contribution to children’s literature he received the Eleanor Farjeon Award and was Children’s Laureate 2007-2009.  In recognition of his contribution to the profile of French culture in the UK, he was made Chevalier de l’Ordre des Arts et des Lettres.    

His YouTube Channel ‘Kids’ Poems and Stories with Michael Rosen’ has had over 55 million views.

: @MichaelRosenYes

Peter Nydahl

Critical Care Nurse and Researcher,

Christina Jones

From 1990 – 2013 I ran the follow up service for the ICU at Whiston Hospital, Merseyside, UK.

Over this time I undertook a number of research projects aimed at improving physical and psychological recovery, such as “Guided rehabilitation of patients recovering from a severe illness” and “ICU diary to reduce post ICU PTSD”.

In 2000 I completed a PhD on rehabilitation after critical illness and then retrained as a trauma psychotherapist. 

I retired from clinical work in October 2013 and became a trustee for ICUsteps and in 2014 became their research manager, helping researchers design studies relevant to service users, ensuring lay summaries and patient and family information sheets are written in plain English through our information group. On Thursday evenings I help with an online ICU peer support group.

From January 2023 I facilitated support groups for patients and relatives attending ICUsteps Active, which is an eight week online exercise group for ICU patients run by physiotherapists. 

Zara Slattery

Graphic Novelist, Illustrator, Tutor and Former ICU Patient,

Zara Slattery is a graphic novelist, illustrator and tutor. Her first full length graphic novel, Coma, was shortlisted for the Myriad First Graphic Novel Competition 2018. The Arts Foundation Futures Awards 2020 and longlisted for the LDComics Awards 2020.

Arjen Slooter

Professor in Intensive Care Neuropsychiatry at Utrecht University,

Arjen Slooter studied Medicine at the Vrije Universiteit, Amsterdam and worked subsequently as a resident in Neurology in Sint Lucas Hospital, Amsterdam (1994).

He was research fellow in Neuro-Epidemiology at the G.H. Sergievsky Center, Columbia University, New York (1996), and received a PhD in Epidemiology from Erasmus University, Rotterdam (1998), on a thesis on dementia.

During his residency in Neurology at UMC Utrecht (1999-2004), he became enthusiastic for Neurocritical Care.

After a fellowship in Intensive Care Medicine (AMC Amsterdam, 2004-2006), he rejoined UMC Utrecht where he worked until 2022 as a consultant neurologist-intensivist at the Department of Intensive Care Medicine. In 2016, he was appointed as Professor in Intensive Care Neuropsychiatry at Utrecht University.

Dr Slooter was chair of the delirium section of the (American) Society of Critical Care Medicine (SCCM) guidelines on pain, agitation/sedation, delirium, immobility, and sleep disruption, as well as initiator and chair of an international consortium to update nomenclature on delirium and acute encephalopathy. From 2018 to 2023 he was President of the European Delirium Association. In 2022, he made a career shift to psychiatry.

The research focus of Arjen Slooter is on delirium and on neuropsychiatric outcome after anesthesia/surgery or critical illness. Using various methods and approaches (epidemiology, EEG, MRI), he has investigated all aspects of delirium, including its phenomenology and brain network characteristics, detection and monitoring, risk factors, prognosis, prevention and treatment. Research on neuropsychiatric outcomes includes ICU-related risk factor analyses on cognitive decline, mental illness and chronic pain after critical illness and treatment in the ICU.

Arjen lives with his wife Barbara, daughter Pien and son Bas in beautiful Utrecht.

Ben Gibbison

Associate Professor, Cardiac Anaesthesia and Intensive Care,

Ben Gibbison is Associate Professor of Cardiac Anaesthesia and Intensive Care at the University of Bristol and Honorary Consultant at University Hospitals Bristol and Weston NHS Foundation Trust. His clinical training was in London, Australia, Cambridge and the South-West. Ben was a full-time NHS Consultant, before moving to be an academic in 2018. He now cares for people before during and after cardiac surgery for half of his time and conducts research from bench-to-bedside for the other half. His research includes physiological mechanisms, data science and applied clinical research (encompassing multi-centre randomised trials). Much of the applied clinical research involves patients under anaesthesia or in the Intensive Care Unit (ICU) who cannot consent for themselves.