Cookeville Regional Medical Center staff hope a new initiative will help critically ill patients long after they're treated at the hospital. The care of patients in the Intensive Care Unit involves some advanced measures, like sedation. That can lead to some frightening memories and some mental health concerns after discharge.  Patients have a number of issues after they've been released from ICU, including depression and anxiety.

Post-Intensive Care

It's called Post-Intensive Care Syndrome, and it's so new, there isn't a lot of data on it, CRMC Clinical Nurse Specialist Angela Craig said. Craig heard an idea at a conference about how something as simple as keeping a diary can help patients.

One hospital used the diaries in a support group after discharge. Former patients can look at their diaries and make sense of their memories with other patients who have been through it too. Researchers said they believe these diaries will be a benefit to patients and their families who choose to use them. 

Intensive Care Unit

The Intensive Care Unit recently began issuing diaries to patients and their families. They'll soon be offered to Cardiovascular Intensive Care Unit patients and their families as well.  Jarvis said the diaries have spaces for patients and families to record their feelings, memories, questions for hospital staff and even updates from home. 

Jarvis said more than half of the patients in the intensive care setting suffer from delirium at some point during their stay. According to, delirium is a inattention and confusion in the brain. A delirious patient can't think clearly or make sense of what is happening to them. The delirium may fade but the memories can stick around for a long time, causing anxiety, depression and even PTSD. 


The diaries were created by CRMC's ABCDEF team, which aims to reduce ICU stay length and reduce mortality. A lot of thought and planning went into the diaries. They included specific things to write down and consider.

ICU Staff

ICU and CVICU staff are already on board with the diaries, they believe more and more patients and their families will begin using the diaries when they see how helpful they can be.