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Merentola P Longkumer
M.Sc Tutor
Nursing ICU in-Charge, CIHSR
Knowing that someone you know is in the ICU is naturally very worrying. You are likely to feel confused and upset, and anxious to help in any way you can. Visiting them can be even more difficult.
You won’t be allowed to enter ICU straight away
The ICU is reserved for serious patients at the hospital where patients are monitored constantly and receive life support. The ICU is a secure area, which means the doors will be shut and if you’re not a hospital staff, you can’t just walk in.
When a person is first admitted to the ICU, staff (doctors and nurses) might take a couple of hours or more working on them to understand what’s happening and make them stable if possible. While this is going on, you will not be allowed in the room with them and will be asked to stay in a waiting area, even if you have come to the hospital with them.
Until they’ve done their work, the staff won’t really be able to give you an idea of what’s going on. This can be difficult, but it’s important to remember that the priority for staff is to save the life of your loved one.
Prepare for overstimulation of senses
When you’re allowed in to visit, you’ll notice that the ICU is not like other hospital wards. There will be a lot of noise from various machines around each patient, the lights will be bright and the atmosphere can feel totally clean. Staff may need to move around you and work with the patient without talking to you much.
When you’re already worried, this can all be overwhelming, particularly when you see your relative lying on a bed surrounded by machines and tubes. They may not be conscious and may show signs of illness. If they are ventilated, which means a tube is inserted down their throat to help them breathe, they will be unable to talk to you even if they are awake. They may not look or feel like your relative at all.
It’s not easy to prepare for this, but your understanding of situation can help. It can also help to know that there is no right or wrong way to feel, and how you feel and react to what’s going on may change often. The staff know that the ICU can be a scary place to be, and will try to prepare you for what you’ll see and experience when you’re invited in and do their best to look after you.
Visitors and visiting hours are strictly limited
Most wards of a hospital will have visiting hours, but the ICU’s are more strict than others. Most hospital ICU might allow only one visitor or two per patient at a time and only at limited times of the day.
You may be asked to wear special protective items, like a gown, gloves or mask when you visit and to wash your hands or use the anti-bacterial hand rub kept near the patients bedside before and after going near a patient.
Staff may require you to leave the ward if your loved one or another patient’s condition changes and they need life saving treatment.
You will meet a lot of different staff members
ICU staff work in a tight knit team. Unlike in a general hospital ward, where one doctor will be assigned to work with a patient, your loved one will be treated by a rotating team of specialist ICU doctors. An ICU nurse will always be by the bedside caring for your loved one.
Other specialists will also visit the ICU. Physiotherapists, dietitians and medical imaging staff, among others, may work with patients depending on their needs.
How do you raise concerns about patient care
Communication is important between ICU staff and family. The staff normally do all they can to keep relatives informed about treatment options and recommendations. If there is anything you don't understand or want to know more about, ask the staff.
There are several steps that may resolve your concerns about patient care:
• Speak to the nurse who is looking after your relative or to the primary care nurse looking after your relative. Ask them to follow-up with the ICU medical team.
• Ask to speak to the medical team – this may take more than one meeting if you would like to consider the information provided, discuss it with your family and meet with them again
• If you are still dissatisfied – every hospital has a patient advocacy /complaints service. This service is intended to improve communication between families and the hospital and may be of value if every other opportunity to resolve the differences has been attempted.
What you can do to help
Even if they are unconscious, your presence can help the patient. They won’t be familiar with the touch or sound of the doctors and nurses like they will be with you and your voice.
Hold their hand and talk to them, even if you’re not sure they can hear you. You won’t hurt them by touching them gently. Research has shown that patients show positive effects including reduced blood pressure and heart rate when visited by a loved one.
What you won’t be allowed to do
You won’t be allowed to bring flowers into the ICU, as they can spread germs throughout the ward. You also won’t need to bring special clothes or pyjamas for your loved one to wear, because the staff will need them to wear a hospital gown that allows them to provide intensive care therapies.
You are not allowed to take photos or share photos of a patient in ICU who is unable to give their consent to being photographed. Staff may ask you to delete photos if they see you taking them without permission.
You will be asked to turn off your phone when visiting the patient.
You will be asked to remove your footwear and wear only the one available in the ICU during the visiting hour.
It’s important to look after yourself
Even though you’re caring about someone who is very unwell, your wellbeing is also important. You still need to eat meals, try to get some sleep and look after yourself. You might need to look after other family members, arrange for time off work or keep your own appointments. If you take regular medications, ensure that you remember to take them.
