Publicerad den april 19, 2023 av Lars Carlén

Translation from Swedish by Andreas Lindahl

There is a lot in this black-and-white photo from the intensive care unit at Danderyd Hospital that reveals that it is from another time. Someone who has experienced first-hand how ICU care has developed in recent decades is nurse Eva Barkstad. She has worked as a specialist nurse in intensive care for 39 years and most of that time at Danderyd Hospital. The photo was taken back in 1964.

This is what it looked like in the ICU at the ICU at Danderyd Hospital in 1964. Photo: Ateljé Sundahl.

”When I saw the picture, I thought it was funny. The way it looks in the picture, it certainly didn’t look like that in 1984 either…”

Although she remembers that the intensive care unit was significantly more technologically advanced as early as 1984, compared to what is shown in the picture, she notes that during her 39 years in healthcare, the technology has continued to develop at a rapid pace.

Today, when news reports from the Swedish healthcare system usually address problems, it is important to also highlight how much has improved in Swedish healthcare. Although, of course, there are challenges, such as a lack of resources, that need to be solved. Eva Barkstad has experienced how patient safety has increased with ever better technology. So, in what way is the technical equipment different today compared to 1984 in the ICU? That is, 20 years AFTER the photo was taken.

5 improvements in the ICU

These are some of the differences that Barkstad mentions:

1 Fewer samples

Over time, technology has become increasingly adept at helping healthcare professionals monitor the health status of ICU patients. Also compared with how it was in the mid-1980s.

2 The precision and safety of equipment have increased

In addition to technology becoming an increasingly better tool to help staff monitor patients’ health status, the increased precision of the equipment has in many ways increased patient safety. Today’s equipment that connects patients in the ICU to technology has also meant that the staff do not need to take as many samples, as technology constantly shows the staff so many different parameters of the patients’ condition. The improvements have been made through an interplay between research and technology development. This is closely linked to research progress and increasingly better ways of working.

”If we take ventilators as an example, they could of course provide air to patients even forty years ago. The difference is that with today’s technology, we can set exactly what the individual patient needs,” she says.

Eva Barkestad describes how all the technical equipment in the intensive care units has been greatly improved. Another example is infusion pumps that allow patients to get the right dosage of drugs, which is important with potent drugs.

Previously, a lot of equipment in the ICU was sensitive to radio waves that had the same frequency. If devices were placed too close to each other, measurements could get out of hand. These are problems that have disappeared as technology has evolved. Technical incidents gradually began to be recorded and followed up to make technology safer.

3 More teamwork

On the other hand, the way work is organized has changed. 40 years ago, each patient usually had their own room with an assistant nurse in the room. One nurse was responsible for 3-4 patients. The next step that was asked for was a doctor. The assistant nurse rang the nurse when something happened and every now and then the nurse called a doctor. The working method that Eva Barkestad describes today at IVA is that the professional categories work as a group in a completely different way. Work is less hierarchical.

4 Enhanced possibilities to save seriously ill patients today

Patients in intensive care units today are much more seriously ill than they were 40 years ago.

”40 years ago, patients died at a higher rate without us being able to do anything. Today, there are far more patients that we can do something for, so that they get back to a good life soon.”

Same stress, now as then

When it comes to how stressful it is to work in the ICU, Barkestad feels that there is something that has not really changed since her first day as an ICU nurse.

”Sometimes there’s a lot to do. Eight hours can go by when I’m not even sitting down, I’m busy with a patient. Then it sometimes happens that you just sit and end up wondering if something will happen soon. To work in the ICU, you have to like the adrenaline rush,” she says.

Text: Lars Carlén