Being in intensive care
If you or someone you love is admitted to intensive care it can be a time of considerable stress and worry. It may be helpful to understand what you can expect to happen in intensive care, both as a patient and as a relative.
The intensive care team is multi-professional, and will include doctors, nurses, psychologists, physiotherapists, speech and language therapists, dietitians, pharmacists, occupational therapists, and many other allied healthcare professionals. They are there to care for you, or your loved one, and to answer your questions while in an intensive care unit (ICU).
Admisssion
Once you're admitted it can take an hour or more to begin treatment to stabilise your illness. You may still be recovering from anaesthetic following surgery, or you may have been sedated and put on a ventilator as the first stage of treatment.
Visitors may be welcome and are likely to see various pieces of medical equipment connected to you, and a high level of activity from ICU staff.
An ICU is louder than a regular ward, partly because of the equipment which, to keep you safe, may alarm frequently. If you hear an alarm it doesn't necessarily mean anything's wrong, just that there's something the staff need to be aware of or attend to. The staff caring for you will explain the equipment and noises if you are concerned.
The first few hours on ICU are often an unstable time and your condition can change often. Even if you're sedated one of the team is likely to summarise what has happened so far and what they expect in the next few hours. Don't be afraid to ask questions as soon as you feel able.
It's important for your relatives to be supportive and positive. You may be confused or bewildered because of your condition or the sedative medication. It will reassure you and help your recovery if your family explain what has happened to you.
Research
Advances in medical knowledge and treatment have been brought about through research, and medical practice today is based on evidence of what works.
There are always research trials being undertaken in intensive care units around the country into different aspects of care, all of which have to be approved by an independent ethics committee of outside experts.
Patients, and increasingly relatives, are sometimes asked to take part in research trials. ICUs have staff supervising these trials who will seek patients’, and sometimes relatives’, consent to take part in an approved trial.
Taking part is entirely voluntary and there is no obligation to consent. Even after giving consent withdrawal can take place at any time.
The full details of any trial will be explained by the staff in the unit who are co-ordinating it.
Mood Changes
It’s not uncommon to feel like you’re getting worse before you get better, but it’s important to stay positive and to know that those caring for you are always working to help you get better.
Sedation can make it difficult to think clearly. It might change your perception of what’s happening and you may seem angry, hostile, or just different, but this change will not be permanent.
Weakness and weightloss
During your stay in intensive care, you may lose weight and muscle tone. Joints can also become stiff due to the long time spent in bed, and there may be some loss of sensitivity in the fingers and other small joints.
This can be distressing, but, as you become more active, muscle weakness and joint stiffness will improve as part of the recovery process.
Halluciations, Delusions and Nightmares
Some ICU patients remember nothing at all about their stay, some remember very little, but most patients can recall the days immediately following the removal of the breathing tube (extubation), although these memories are fragmented. Many people who have been treated in ICU remember unreal experiences in detail - particular objects, individual nurses and important emotional experiences.
Don’t be afraid to discuss your experiences with the nurses, and no that no matter how strange, frightening, or even pleasant they are, it’s very rare to experience them after recovery.
Poor recall and loss of memory are due to a combination of the type and severity of the illness, drug treatment and other factors that are, as yet, not understood completely.
Transfer to another hospital
Sometimes you may need be transferred to another hospital because it has the very specialised care you need. This should be done during the day whenever possible, although it may, because of a sudden emergency, occur during the evening or night.
The decision to transfer is always made by the most senior doctors and nurses and all transfers to another hospital must be carried out strictly in accordance with nationally agreed procedures to safeguard your wellbeing.