Having a loved one in an Intensive Care Unit can be very distressing. It is normal to feel confused, anxious and upset. The information provided is designed to answer common questions families have about intensive care.
What is an Intensive Care Unit?
An Intensive Care Unit is a highly specialised area within a hospital dedicated to providing continuous, round-the-clock care to patients with severe or life-threatening conditions. These patients often require intensive monitoring, specialised equipment, and high levels of medical intervention to stabilise their conditions, manage complex symptoms, and support vital functions such as breathing, heart rate, and circulation.
Intensive care is a specialised area of a hospital where patients with life-threatening illnesses injuries or post major surgery receive round-the-clock care. Patients in intensive care often need close monitoring, advanced medical treatments, and constant support to help them recover.
What types of machines and treatments are commonly used in the ICU?
In the ICU, patients may be connected to machines that help them breathe (ventilators), monitor their vital signs (heart rate, blood pressure, oxygen levels), and administer medication. Treatments may also include intravenous fluids, hemofiltration, and advanced life support measures.
Why are these treatments necessary?
These treatments are essential to support the body’s vital functions when it is too weak or sick to manage on its own. The equipment helps the medical team track a patient’s condition and respond quickly to any changes.
What are the rules for visiting someone in the ICU?
Visiting policies vary by hospital, but ICUs generally allow close family members to visit, often with restrictions on the number of visitors and visiting hours. The ICU staff will provide guidance on when and how to visit safely and whether it is the right time to bring children to intensive care.
Seeing a loved one in ICU can be confronting. The patient may be connected to a number of machines with visible tubes and drips. The fluids given to a patient to keep them hydrated may make them look bloated and bruising can be caused by tubes and injections. This is normal and will improve as the patient recovers.
Many machines in ICU have alarms that alert staff for routine tasks, like adjusting drips, rather than emergencies. If the patient is on a ventilator, the staff may have to regularly clear the chest of mucus and fluid. They do this by putting a thinner tube into the breathing tube to suck up the mucus. This is quite noisy and may cause the patient to cough or retch.
There may be times when staff will ask you to leave the patient’s bedside. This is because some of the necessary medical procedures may upset you. It also gives the staff room to do their job.
Who makes decisions about a patient’s treatment?
The ICU medical team, led by an intensivist, makes decisions about treatment based on the patient’s condition. ICU teams consist of specially trained healthcare professionals, including intensivists (doctors who specialise in critical care), nurses, pharmacists, physiotherapists, and other allied health professionals. They all work together to provide the best possible care for critically ill patients. Regular team meetings and ward rounds ensure everyone is up to date on the patient’s progress. In most cases, they will consult with the patient’s family, especially if the patient is unable to communicate.
How can families be involved in those decisions?
Families are encouraged to ask questions and stay informed about the patient’s treatment plan. In some situations, families may need to help make important decisions, especially regarding life-sustaining treatments.
How is the length of stay in ICU determined?
The length of a patient’s stay in ICU depends on their condition, how they respond to treatment, and the complexity of their care. Some patients may only need a day or two, while others may require longer stays.
What factors influence when a patient is moved out of intensive care?
Once a patient’s condition stabilises and they no longer need intensive monitoring or life-support treatments, they may be transferred to a regular hospital ward or a step-down unit. The medical team will decide when it’s safe to make this transition.
Patients may feel confused or have disturbing dreams due to illness or medication while in ICU. This behaviour can be extremely distressing to witness but be assured that this is not uncommon in ICU and will improve as the patient’s condition improves. If the patient has been given sedatives, these will be gradually reduced as the patient gets better. As the patient is weaned off the sedatives, they may be drowsy and confused, particularly in the early stages, but it is a necessary step and an important part of recovery.
When someone you love is in ICU it is very natural to experience a myriad of emotions – fear, anxiety, guilt, exhaustion, confusion, helplessness. It is important to take care of yourself by eating and resting, even if you don’t feel like it. You shouldn’t feel guilty for not being by the bedside 24 hours a day. You will be needed to be fit and healthy when they return home.
What is the next step for patients after they leave ICU?
Many patients are transferred to a step-down unit called high dependency or a regular hospital ward, where they continue to receive care, but with less intensive monitoring. Depending on their condition, some patients may also require rehabilitation services to help regain strength and function.
How can families help in the transition out of the ICU?
Families can support their loved ones by staying involved in their care, asking questions about what to expect next, and helping with their recovery process. The medical team can guide you on how best to support the patient at each stage of their recovery.
Leaving hospital and returning home is a major step in a patient’s recovery but it will take time and effort to get back to a normal life.
Before you leave hospital, your physiotherapist may give you an exercise plan to help with your recovery. You may also be assessed to identify any psychological or emotional problems you are likely to experience once you are home, as well as any care and equipment you need. Your healthcare team should discuss with you what your rehabilitation goals are and organise any referrals and care you will need.
You should not expect too much of yourself once you are home. Physically and mentally, you have been through a major ordeal, and you’ll probably feel very tired and won’t have much energy. It will take time before you feel well enough to cope with everyday life and many more months to get back to full strength.
It is normal to feel depressed or frustrated because you don’t seem to be getting better as quickly as you hoped. Set yourself small goals and slowly increase your activity to build up your strength, but make sure to rest when need it.
For some patients and families, being critically ill can be a very traumatic experience and it may take time to come to terms with it afterwards. Your mood may change often, and you may experience anxiety and sadness about your slow recovery, your dependence on others, not being able to sleep, your fear of becoming ill again or your loss of appetite. All these worries can make you moody, quick-tempered, depressed, fearful and insecure. It is an important part of your recovery to express your thoughts and feelings. Talk to your loved ones or visit your GP who may offer you treatment or counselling to help you through this difficult time.
During your illness, your muscles may have weakened, especially if you were on a ventilator. You may have lost weight and noticed changes like dry skin and hair, bruising, or altered senses (taste, smell, etc.). These symptoms should improve as you regain strength and rehydrate.
It’s common to have trouble concentrating or remembering things, but this usually gets better over time. Some patients experience temporary bladder control issues after having a catheter in ICU. Don’t worry, this usually returns to normal. If you feel pain or have difficulty passing urine, speak to your doctor.
While you were in ICU you will have received your food as a liquid, through a tube inserted into your nose and down into your stomach, or by a drip straight into your vein. Now you may have difficulty eating because you don’t feel hungry, your mouth is too sore to eat, food tastes different or it hurts to swallow.
Try starting with small portions and eat more frequently. Nutrient-rich drinks like those provided in the hospital can help with recovery. Take your time and rest after meals to aid digestion. It’s normal for some foods to taste unusually sweet or salty, this usually improves as your taste buds adjust.
Staying hydrated is important so ensure you drink plenty of fluids. If you’d like to drink alcohol, check with your doctor first to ensure it’s safe with any medications you’re taking.
What support services are available for families of ICU patients?
Most hospitals offer a range of support services for families. Emotional support can come from on-site counsellors, social workers, or chaplains, who are available to listen and help families cope with the stress of having a loved one in ICU. Hospitals often provide informational pamphlets, resources, or access to support groups to help guide families through the ICU experience.
Where can we get more information about coping with the ICU experience?
How does the ICF support ICU research and education?
The Intensive Care Foundation’s vision is to provide excellence in intensive care. Our aim is to advance the quality of life, treatment outcomes, and survival rates for those in intensive care, saving more lives across Australia and New Zealand. The Foundation funds cutting-edge research and supports education programs for ICU healthcare professionals. These initiatives lead to better treatments, new technologies, and improved outcomes for patients both during and after intensive care.
How can I get involved with or support the work of the ICF?
There are many ways you can support the important work of the Foundation. You can make a donation, consider a gift in your will, organize a fundraising event, or volunteer your time. Every contribution helps fund lifesaving research, education, and the development of better ICU treatments.