Early Mobilization in the ICU

Critical illness can turn a previously independent patient profoundly weak within days. Inflammation drives catabolism and neuromuscular injury; deep sedation, mechanical ventilation, and bed rest then remove the movement needed to preserve strength. The result may be delayed ventilator liberation, a longer ICU stay, and disability that persists after discharge. Mobilization is not synonymous with walking. For one patient, the appropriate session is positioning and passive joint movement; for another, it is sitting at the bedside or taking steps with a coordinated team. The goal is to match activity to present physiological reserve, not to force a predetermined milestone. In Canadian ICUs, early mobilization aligns with the Choosing Wisely Canada recommendation to avoid prolonged sedation and bed rest during mechanical ventilation. Its delivery is interprofessional and protocol-dependent. The precise authority for an NP to initiate or progress mobility independently must follow provincial regulatory requirements and local ICU policy.