Information for relatives and friends
Introduction
This guide aims to give practical support and
information to people whose loved ones are admitted to an Intensive
Care Unit (ICU) or a High Dependency Unit (HDU). Such units may be
run separately or as combined departments. Our Critical Care Area
combines ICU and HDU beds although it is referred to as ICU. HDU
care is for patients who require less monitoring or treatment than
ICU patients.
Hospitals and their procedures are unfamiliar
to most of us and you may be feeling shocked and confused at this
time. This is a general guide to our ICU, its set-up, routines,
procedures and treatments. Please do not be afraid to ask staff
questions to supplement this information.
Our ICU is a 10-bedded unit caring for adults
and children who are seriously ill or who have required major
surgery. Our aim is to provide the best possible care to all our
patients, their relatives and visitors. The needs of the patients
and their families are respected and met wherever possible. The
care given takes account of religious beliefs and cultural
differences.
Admission to a critical care area
Some admissions to a Critical Care Area are
planned, usually after major surgery or in order for certain
specialist treatments to be performed. In such cases it may be
possible for you and your relative to be seen by an ICU nurse who
will explain in more detail what will happen.
However, most admissions are in emergency
situations. A patient whose condition is extremely serious,
possibly life threatening is often taken to a Critical Care Area.
Critical Care Areas provide high levels of medical and nursing care
with doctors and nurses constantly on hand. There are more staff
present than on an ordinary ward.
You may have arrived at the hospital while
assessment of your loved one’s condition is taking place. Time can
pass very slowly when you are waiting for news. You will be shown
to a waiting area where we will inform you of what is happening as
soon as possible. When a patient is brought to a Critical Care Area
it can take more than an hour for the doctors and nurses to assess
the patient’s condition, make them as comfortable as possible and
attach them to the necessary equipment. It is normal to have to
wait away from the bedside at this time, but we know that it can be
frustrating and a member of staff will Zxplain what is happening
and let you see your relative as soon as possible.
What is a critical care
area?
Patients whose conditions are life
threatening, either through serious injury or illness, need
constant close monitoring. They often need equipment and medicine
to support normal bodily functions such as breathing. This care is
provided in ICU or HDU – the Critical Care Area.
The length of time patient’s stay in a
Critical Care Area depends on the extent of their illness or
injuries and any further complications. Some patients will recover
quite quickly while others may remain in the unit for weeks or even
months. Sometimes a patient’s condition can fluctuate, - for
example they may develop an infection.
Recovery is not possible in all cases and
sometimes a patient dies. Sometimes it is necessary to move a
patient to a different department or even a different hospital to
give them appropriate specialist care.
Sometimes a patient is transferred to a
different hospital due to a shortage of beds but this only
happens when every other option has been exhausted.
Visiting the critical care
area
What does our Critical Care Area look
like?
Our ICU has 11 bed spaces, 2 of which are side
rooms. The unit is open plan. We do not have separate male and
female sections but every effort is made to ensure privacy and
dignity is maintained. Around each bed space you will find varying
amounts of medical equipment, which will be explained by the nurse
looking after your relative or friend.
Entering the critical care area
Relatives are welcome to visit at anytime.
Friends are also welcome but only with the permission of the next
of kin or the patient.
On your first visit to the unit please ring
the bell in the relatives waiting area. A member of staff
will then escort you into the department. On subsequent visits you
do not need to ring the doorbell but are welcome to come straight
into the unit to your relative.
You must use the alcohol hand rub on your hands before and after
visiting your relative or friend in order to minimise spread of
infections. Containers of hand rub are found at the entrances to
ICU and at every bed space.
Please do not be alarmed if the curtains are
around the bed space – your relative will be receiving a treatment,
which requires privacy, and you will need to wait in the relatives
waiting area. In this case please let a member of staff know who
you are visiting and they will ensure you are allowed in as soon as
possible.
You may find your visit interrupted by a
treatment or examination and the nurse or doctor will ask you to
leave the bedside and wait in the relatives waiting area. Please be
aware treatments and examinations may (and usually do) take longer
than anticipated.
Patients do have a rest period from 3.30p.m. –
5.00p.m. and we would ask you not to visit the unit at this time.
If this is a particular problem please mention it to the nursing
staff. In exceptional circumstances, visiting can be negotiated
with the nurse in charge.
Please feel free to contact us at any time.
However we would appreciate you nominating one member of the family
to phone for a progress report, as it may be difficult to give
information to those we do not know and time consuming to repear
the same information to several different people.
Noise levels in a critical care area
It can be quite noisy in the Critical Care
Area, especially during the day. There may be bleeping noises
coming from some of the equipment and even an occasional alarm
sound. This is normal and does not necessarily mean that something
is wrong.
Will I recognise my loved one?
Your loved one may look very different from
the last time you saw them. Their clothes will have been removed
but they will be covered. Their bodies may be bruised and swollen.
They may be attached to a lot of equipment. The doctors and nurses
will tell you what to expect.
Can I touch my loved one?
Tubes and wires often surround the patient in
critical care, however it is usually possible to touch your loved
one. The nurse will guide you. After a few visits you may feel you
would like to participate in some of the care your loved one
requires for example: combing their hair, cleaning their eyes and
mouth or washing their face. Please mention this to the nurse and
she will help you carry out these cares. If you are involved in
helping care for your relative you must wash your hands and
wear an apron.
Can I talk to my loved one?
Patients in critical care are often
unconscious, at least during the early part of their treatment.
This is because they are being given drugs or medicines to make
them sleepy and comfortable. However, a patient may be able to hear
even if they cannot respond. Staff will talk to unconscious
patients and tell them what is happening. Feel free to talk to your
loved one and let them know that you are there. Tell them who you
are and talk to then about day to day activities; feel free to read
a newspaper, magazine or book to them as it can be difficult to
maintain a one way conversation.
It is normal to feel upset at seeing someone
in critical care. It is understandable if you find it hard to cope.
We are here to help you and answer any questions you may have. You
may find it helpful to have someone to visit with you.
The daily routine
All patient’s needs vary and thus there is no
typical day. Mornings tend to be the busiest times. A ward round is
held from approximately 08.30 to 10.30hrs where the doctors and
nurses discuss the patients’ progress and care, examine the
patients, decide on further treatment and make a plan for the rest
of the day. There is also an evening ward round from approximately
17.30 to 18.30hrs
Patients in critical care areas are vey ill
and their conditions may change quickly. Information you receive
may sound different on a daily basis. You may find it useful to
speak to the same doctor or nurse, although this is not always
possible. If you are confused about your loved ones condition, tell
the staff and ask for further explanation. Be prepared to gather
significant family members to meet with the Consultant for
condition updates.
Patients’ property
We have very limited space in the unit for
storing property and therefore we ask that the patients only have
essential toiletries and cards. Photographs of family and friends
to display are also welcome. Suggested toiletries include liquid
soap, deodorant, toothpaste, toothbrush, hairbrush and comb,
moisturisers, shaving equipment.
Money and other valuable items e.g. jewellery
need to be taken home or locked away in our safe.
Children can have their favourite toys and
long stay patients can use walkmans and Discmans with favourite CDs
and cassettes. We do have televisions, radios, CD, video and
cassette players in the unit.
The hospital cannot accept responsibility for the loss or damage
of items not handed in for safekeeping.
We do have televisions, radios, CD, video and
cassette players in the unit, together with talking books funded by
donations from relatives and the League of Friends
Photographs
We do not allow relatives or friends to take
photographs of patients as this is a breach of an individual’s
rights to privacy and confidentiality.
Mobile phones
Please do not use mobile phones in the unit.
Patients and visitors can use mobile phones in public and communal
areas but please be sensitive to the needs of others when using
your phone. Phone cameras are not to be used for breach privacy
reasons as highlighted above.
Flowers are not allowed on
the unit for control of infection reasons.
Who are the staff in the critical care
area?
The staff in the critical care area work as a
team to care for patients. It is likely that you will meet many of
the staff who look after your loved one as the days go by.
The most senior doctor in the department is
the consultant. Consultants specialise in a particular area of
medicine. Our ICU is run by 7 consultant anaesthetists.
Anaesthetists run most critical care units. Anaesthetists are
doctors who specialise in supporting breathing and circulation in
unconscious patients. Sometimes doctors who specialise in critical
care are called intensivists. Other doctors called registrars and
senior house officers assist consultants.
Other specialist doctors will visit the area
to advise on particular aspects of patient treatment and care.
A doctor will always be available to ensure
that any change in a patient’s condition is treated promptly and
appropriately.
The nurses in the unit are sisters, senior
staff nurses and staff nurses with health care assistants and
support workers who assist the trained nurses all of these are
overseen by a Senior Sister. For ICU patients, there is usually one
nurse per shift to care for the needs of one patient and their
family. However one nurse may care for 2 HDU patients. There is
usually one senior staff nurse or sister who is in charge of the
shift and co-ordinates the team.
There are often nurses on duty who are
undertaking specialist courses, general nurse training or being
orientated to the unit because they are new or from another
department. These nurses are often working with another member of
the nursing team in order to develop skills and knowledge in this
area.
The staff wear the same uniforms as staff in
the rest of the hospital. Doctors sometimes wear green or blue
theatre scrubs. Sisters wear navy blue tops and trousers or
dresses, senior staff nurses wear royal blue and other staff wear
pale blue. All staff should be wearing name badges and photo
identity badges with their name and job title. We also have a board
with staff photos to help you identify who’s who.
We have two departmental
secretaries. They help with the smooth running of
the unit by greeting visitors and dealing with telephone enquiries.
They will be able to give you some information about your loved
one, but they will also be able to find the most appropriate person
to deal with your questions.
Our ICU has 2 technicians who
maintain all the equipment used. They check and clean equipment as
well as train other members of staff and occasionally help with
procedures.
Some of the sisters have specialist roles
within the unit e.g. bereavement, research, audit, patient follow
up, organ transplantation.
Staff who visit critical care
areas
Twice a day a team of
physiotherapists (physios) led by a senior physio
visit the ICU. They may treat a patient’s chest, to clear
secretions from their lungs. Many patients are at risk of
developing chest infections because their lungs are not functioning
well enough to prevent the build up of secretions. Physiotherapists
are also involved with the rehabilitation of the patients by
helping them to exercise their limbs, sit out of bed, stand and
walk, as they are able. Again after a while you may like to be
involved in helping with the limb exercises and the nurses and
physios can show you how to do this.
A radiographer takes X-rays
of patients, either in the unit using a portable machine or in the
radiography department. They also perform ultrasound scans. If
patients are having X-rays in the unit you may be asked to leave
while the X-ray is taken to avoid unnecessary exposure to the
rays.
A pharmacist is involved in
monitoring the effects of medicines on patients. Pharmacists also
ensure that the department has sufficient supplies of
medicines.
A dietitian ensures that each
patient is receiving the appropriate type of food and is receiving
enough calorie and nutrients.
A speech and language
therapist may visit the area to assess swallowing or
speech function in conscious patients who have had
tracheostomies.
The Critical Care Outreach
Service is a small team of nurses who have considerable
intensive care experience, who visit patients on the general wards.
The purpose of the Outreach team is to support the ward staff, and
advise and help in the care of patients who may need more
observation and intervention. The transition between the ward and
the intensive care unit can be a stressful time for the patient,
their relatives and the staff looking after them and the Outreach
team aim to make that transition as smooth as possible.
The Nurse Consultant for Critical
Care is the lead nurse for critical care issues in the
Trust. As well as working at the bedside as a critical care expert
in the assessment and treatment of patients, the role includes
advising, educating and supporting a range of clinicians who care
for acutely ill patients anywhere in the hospital. The role also
includes a strategic function that involves giving advice on
critical care services and implementing innovative systems to
improve the care of critically ill patients. Knowledge of current
research and national and international policy helps to keep the
trust at the forefront of critical care practice.
The hospital chaplains are
staff members and part of the caring team. We have contacts with
individuals from most faith communities. The chaplains befriend,
support, offer prayer and the sacraments. Someone is available
24hours a day, 7 days a week. If you would like a Chaplain to visit
ask one of the nurses or secretaries to contact them. A chapel is
located in the very front of the hospital in North Wing and there
is a Sanctuary located on the Concourse, Level 2. This room
accommodates all faiths and none.
Patient Advice and Liaison Service
(PALS). PALS offers on the spot help when things go wrong
and is a link between you and the hospital. They can also refer you
to specialist agencies as appropriate and help you make a
complaint. PALS can guide you, your family and friends through the
different services at the Trust and can help you sort out any
concerns you may have about the care or services you receive. The
PALS office is on Level 2 in the main entrance or ask nursing staff
to contact PALS on ext 8338 or telephone direct on 0118 322
8338.
What does the equipment
do?
Equipment surrounding patients is usually
there for one of two reasons, to support normal bodily functions
and to monitor the patient’s condition.
1. Equipment that supports a patient’s
normal bodily functions:
Breathing equipment
A ventilator is a machine that assists a
patient’s breathing. A tube is inserted through either the
patient’s nose or mouth and into the windpipe. The tube, which is
known as an endotracheal tube, is connected to a machine that blows
air and extra oxygen in and out of the lungs. The machine can
‘breathe’ completely for the patient or it can be set to assist the
patient’s own breathing. A patient can gradually be weaned off
a ventilator as their condition improves.
If the patient is likely to remain on the
ventilator for more than a few days, the endotracheal tube is
sometimes replaced with a tracheostomy. In this case an operation
is performed to insert a tube into a hole made in the throat. This
procedure is usually carried out in the unit. Although the
tracheostomy can look strange it is actually quite comfortable for
the patient compared to having the tube in the mouth. A patient
will not usually be able to speak while the endotracheal tube or
tracheostomy is in place but this is temporary and speech will
return when they are removed. The tubes also mean the patients
have difficulty swallowing and coughing to clear phlegm from the
chest. A very fine suction tube is passed down the endotracheal
tube or tracheostomy to suck away secretions and saliva is also
removed from the mouth with a suction tube rather like the dentist
does.
Occasionally the ventilator will alarm to
alert the nurse to a change in the breathing support. This does not
necessarily mean there is something wrong.
Most critically ill patients require extra
oxygen. This may be given through the ventilator or via a mask.
Equipment for fluids
Patients are often attached to drips. These
allow liquid to be passed through tubes into veins, usually in the
side of the neck, arm or hand. There are various substances
commonly used in drips.
A patient may need blood. The amount of blood
to be given is carefully monitored. Blood is made up of several
substances, for example plasma and platelets, which can be given
separately if this is specifically what the patient needs.
Medicines are often given through a drip.
Medicines are discussed in a separate section. Often a pump will
deliver the medicine at a specific rate.
Fluids are often given via a pump to ensure a
continuous flow. Fluids are given for re-hydration and to maintain
blood pressure.
Food in the form of a liquid containing
essential nutrients can be given either through the nose via a tube
into the stomach or through a drip.
Again the pumps used to deliver fluids or food
will alarm when the infusion is complete.
Tubes that drain waste from the patient can
often be seen attached to the bed.
Kidney equipment
If the patients kidneys are working normally
the nurses will measure how much urine is being made every hour. To
do this a urinary catheter is passed into the patient’s bladder.
You will see the tube attached to a bag, which hangs at the side of
the bed.
If the patient’s kidneys are not working
properly a haemofilter machine is used. It works in a similar way
to a dialysis machine. The haemofilter removes blood from a vein
through a tube then pumps it through a filter to remove excess
fluid and waste products. Once the blood is clean it is returned to
the patient. Haemofiltration is usually done continuously. Again
there are alarms on the machines, which will signal the end of a
period of treatment.
2. Equipment, which monitors a
patient’s condition:
Equipment to monitor the
heart
Each patient is attached to a machine called a
cardiac monitor or ECG, which monitors his or her heart rate. Small
sticky pads are placed on their chest and are connected to the
monitor. The monitor picks up electrical impulses from the
patient’s heart and can detect any abnormalities. The monitor can
also show the patient’s breathing rate, blood pressure, central
venous pressure (CVP). It is normal for the numbers shown on the
monitor to keep changing. Again the monitor will alarm if there is
a change but this may not necessarily be a problem.
The blood pressure is monitored by inserting a
small drip into an artery in the wrist or foot. We are also able to
take blood from this line for routine blood tests. The CVP is
monitored by inserting a line into the neck and attaching it to the
monitor. This line can also be used for giving fluids and
medicines.
Equipment to monitor oxygen
requirements
A probe, rather like a peg, is placed on one
of the patient’s fingers, ears or nostrils, which measures the
percentage of oxygen in the patient’s blood. This is displayed on
the monitor and can help the nurses and doctors adjust the oxygen
requirements of the patient. The nurse will change the position of
this probe every few hours.
Equipment to monitor head
injuries
If a patient has a serious head injury it is
important that further damage to the brain is prevented. It is
essential that any brain swelling and increases in pressure are
detected and treated promptly. A small pressure gauge may be
inserted through the skull into the brain to measure the pressure
inside the skull. Although this may look alarming it does not cause
the patient any pain.
Do ask staff to explain the equipment and what
is happening.
Investigations: the following
investigations and procedures are used if appropriate:
A CT scan (Computerised Axial Tomography) may
be taken. A series of X-rays of the body are analysed by computer
to show a patient’s body as if it were a series of layers. This
provides more detailed information. This investigation takes place
in the X-ray department as does and MRI scan.
An MRI (Magnetic Resonance Imaging) is used
less often than a CT scan. It is similar but is sometimes needed to
show finer detail.
An ultrasound scan can be used to see a more
detailed picture of the heart (called Echocardiogram) or the
stomach or abdomen. This can be carried out on the unit.
An electrocardiogram (ECG) provides a detailed
picture of the patient’s heart.
An electroencephalogram (EEG) can detect
changes or abnormalities in the brain.
An endoscopy enables the doctors to see inside
a patient’s body without an operation. Flexible tubes, which
transmit, light are passed into the body to look at the lungs,
stomach or intestine.
These last three investigations usually take
place on the unit.
Medicines used in the critical care
area
Medicines or drugs are an essential part of the treatment provided
in critical care areas. The amount and type of medicine given to
the patient will vary according to their condition and progress.
Medicines to stop pain
Analgesics are commonly known as painkillers.
The types of analgesics used in critical care can be very powerful
and can make patients drowsy. Painkillers can be given through a
drip, by mouth or the tube into the stomach, by injection or as
suppositories. Some patients have an epidural placed in their back
through which painkillers are administered continuously.
Medicines to keep a patient
rested
Sedatives are used to keep a patient in a deep
sleep or in smaller doses to keep a conscious patient calm. This
helps patients tolerate the tubes and equipment attached to them.
Some sedatives cause patients to temporarily lose their short-term
memory.
Medicines to keep the patient
still
Sometimes additional medicines are given to
the sedated patient to stop any muscle movement and allow them to
be attached more comfortably to the breathing equipment. These
drugs make a conscious patient seem unresponsive because the drugs
prevent them from moving.
Medicines to help a patient’s heart
work more effectively
Inotropes are a group of powerful drugs (for
example adrenaline, noradrenaline, dobutamine) that help the heart
work more effectively and consequently support and maintain the
blood pressure.
Antibiotics
These are medicines to fight infections.
Waiting for your loved one to
recover
It is natural for family and friends of a
seriously ill person to ask nursing and medical staff ‘What are
their chances?’ It is not always possible to know what is going to
happen or how long the course of the illness will be. A very ill
patient may improve or deteriorate quickly. Sometimes the health of
a patient whose life is at risk can fluctuate. In this situation we
may say your relative is ‘critically ill’. We will give you as much
information as we can in an honest and open manner.
Critically ill patients are often very weak
and it is possible for serious complications such as organ failure
or infections to develop in addition to their original problem.
Things that may help
If your loved one is in ICU for a long time
you may find visiting becomes harder. It is common to feel helpless
at this time. You might like to pass the time reading to your loved
one either extracts from a favourite book or the newspaper. You can
do this even if they are unconscious.
While your relative or friend is a patient in
ICU you might like to keep an account of significant events which
happen to them by writing a diary. This will give you something
positive to do and often benefits the patient and others at a later
date. You could write about what has happened during the day, the
name of the doctor, Consultant and staff on duty, also the visitors
who came. You could include a plan for that day, any procedures
undertaken or results from tests, or updates. Many patients
eventually like to know of their ‘lost time’ in ICU and how their
family and friends coped. When the time is right the person
concerned may like to read what you have written.
It is easy to forget events that happen, nice
to remember some and by looking back it is possible to help their
understanding of the time spent in ICU. A diary can benefit the
patient, family and friends.
Fear of the unknown can cause worry so do not
be afraid to ask us questions if something is bothering you. It can
be helpful to have someone else to talk to, perhaps family and
friends, perhaps your GP, the hospital chaplain or a representative
of another faith. The Patient Advice and Liaison Service (PALS) is
also available.
Visiting a critically ill patient and coping
with all the other tasks you need to carry out can be very tiring.
It is important to take care of yourself. Try to rest as often as
you can. You could make use of the Rest Period to try to have a
rest yourself, or deal with other matters, which may need your
attention. Sleep during the night not during the day. Remember to
eat sensibly too. You will need your strength.
Facilities available
The waiting areas
We have restricted space for families of all
patients to use. Please treat these areas with respect and if any
accidents happen inform a member of staff as soon as possible.
Please respect each others’ needs for privacy and space. It may be
good to use the waiting time to have something to eat, take a walk
or spend time in the Sanctuary or Chapel.
Accommodation
We have three rooms available for families who
wish to stay while their relative is in ICU. These are intended for
your use during the first few critical days. As you can appreciate
these rooms are in great demand and in order to be able to offer
these facilities to all relatives we would ask that you acknowledge
the needs of other families at this stressful time. It may not be
possible for you to stay for the whole duration of your relative’s
admission and the allocation of these rooms will be reviewed on a
daily basis according to individual need. We ask that there are no
more than 2 people staying in a room. Due to the unexpected nature
of your stay we may initially be able to provide basic toiletries
and refreshments for your first night. In order for us to be able
to provide this service for all families we would be grateful if
you could replace these. There is a fridge available for you to
store food but remember to remove it before vacating the room.
There is also a microwave, and a television in each room. Please
note that these rooms are non-smoking.
These facilities have been provided by the
generosity of others relatives and patients, so please take care of
them. Obviously accidents happen so let us know as soon as a
problem arises. There are near by hotels and please ask a member of
staff for details.
Car parking
Public parking is Pay and Display. Parking for
disabled people is free of charge and the disabled bays are clearly
marked. Parking in other areas may result in being clamped.
The Multi Storey Car Park: Levels 0, 1 and 2
are for the public. Level 2 has disabled spaces and leads straight
to the reception in the main entrance on Craven Road. It is the
best access to the hospital. There are also disabled spaces on
Level 0.
South Block Car Park. There are short stay,
disabled and drop off points only in this car park and next to
South Block entrance as this car park is primarily for staff.
If you need change for the car park there is a
change machine on Level 2, opposite the Main reception desk.
Close relatives of critically ill patients are
eligible for a free parking permit on a ‘one per patient’ basis.
Please ask the nurse in charge or secretary for an application to
complete and take to security (Main reception level 2).
Buses
There is a regular bus service. The bus stops
are located in Craven Road.
Cash machine
There is a cash machine on Level 2 in the main
entrance opposite the reception desk.
Refreshment facilities and
shops
Main entrance Craven Road (level 2):
Convenience store (Whistlestop)
Sandwich and coffee bar
AMT Coffee Cart (level 1)
Open 7 days a week
South Block
League of Friends Tea bar, cards and gifts
9.30am - 4.30pm weekdays
Hospital restaurant
Mon-Fri 7.00am - 7.45pm
Breakfast 7.00am - 11.45am
Lunch 12.00pm - 2.00pm
Supper 5.00pm - 7.45pm
There are also vending machines in the
visitors’ areas for hot and cold drinks, ice creams and snacks
Transfer from a critical care
area
Patients are usually transferred from a
Critical Care Area when they are able to breathe on their own and
no longer need the specialist skills of the critical care team.
They may stay in the Critical Care Area but become a ‘high
dependency’ patient with less intensive monitoring. It may be that
one nurse will look after 2 high dependency patients.
Where the patient is moved will depend on the
nature of their illness or injuries. Some patients will require
further specialist help to assist their recovery and will be
transferred to a unit equipped to deal with their particular
needs.
Most patients are transferred to a ward within
the same hospital. There will be fewer nurses, procedures and less
equipment on a ward compared with the critical care area because
the patient no longer needs them. The more normal atmosphere is an
important step towards recovery and rehabilitation.
Patients often do not remember being in the
critical care area. But sometimes the memory of all the tubes and
machinery, the unfamiliar surroundings and noises and the actual
illness or injuries they have suffered can cause the patient to
feel agitated and confused for sometime afterwards. Relatives and
friends can help by trying to be calm and reminding them of
familiar everyday things. The Follow-up Team will support and
assist in this process.
Any period of critical illness can leave
patients feeling very weak and it can take them a long time to
recover their full strength. Patients should gradually increase
their levels of activity but also ensure they have proper rest.
Patients recovering from critical illness
often have poor appetite and even difficulty in swallowing. Once
the individual is able to eat, it is often best to begin with
regular small tasty snacks rather than big meals.
Talk to the nursing and medical staff if you
or your loved one are worried about the transfer. The Outreach Team
will check up on patients transferred to the ward and advise and
help with any problems. The Follow-up Team will also continue to
offer support and advice even when the patient is discharged from
hospital.
Looking to the future
Follow up
The Follow Up team will monitor both physical
and psychological effects of ICU on the patient and their families.
Contact is maintained from ICU, on the ward and through to
discharge home.
1:1 visits back to ICU and optional clinic
appointments all assist in providing a factual account of the
experience. The review clinics aim to improve physical and
psychological quality of life in the year after intensive care
discharge.
This service also provides quality assurance,
as both patients and relatives give feedback regarding their ICU
experience. With a greater insight, changes in practice occur and
ultimately improve the service for the future ICU patients and
their families.
The death of a loved one
The purpose of critical care is to treat
seriously ill patients who have a reasonable chance of recovery. In
some cases however, a patient may still be breathing with the help
of critical care equipment, but will not regain consciousness or
recover despite all the efforts of the critical care team.
In these situations the doctors may need to
discuss the appropriateness of further treatment or whether it will
simply prolong suffering. Doctors are usually able to warn those
concerned that their loved one may die and provide details of their
condition.
If your loved one dies suddenly, critical care
staff should be able to answer any questions you may have about
your loved ones condition before they died and the medical care
they have received.
If you are unclear about the reasons why your
loved one has died or wish to discuss their illness and treatment,
our Bereavement Care Sister will see you and arrange further
meetings with whoever is appropriate for you. A list of support
groups is also available in our bereavement pack.
It is possible for a patient who has died to
become an organ donor. Organ donation is frequently an option if a
patient who is on a ventilator is pronounced dead as a result of
brain stem death. It may also be possible for organs or body
tissues to be donated within 24hours of death. Some people find
that organ or tissue donation is something positive that can be
gained from a terrible situation, particularly if they know it was
what their loved one wanted.