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For people who can plan their ICU stay in advance | What to expect | After discharge from the ICU | For people who have been ICU patients

 

For people who can plan their ICU stay in advance

 

Can I visit the ICU before my operation?

If you know that you will be going to the ICU following a planned operation, you might consider a short visit to the ICU beforehand. Please talk to the ward staff, who can contact the nurse in charge of the ICU to see if this can be arranged. ICU staff can explain what all the machines do and what to expect.

 

Remember that for most or much of the time you will not be aware of what is happening.

 

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What to expect

 

What does the ICU look and sound like?

What sets an intensive care unit apart from 'ordinary' hospital wards is the access to round-the-clock nursing and medical expertise, intensive monitoring of patients and sophisticated equipment to support body systems that are not working well or have already failed. Unfortunately, this makes the ICU a busy and noisy place, which can be daunting to those who have never experienced intensive care before.

 

Why is the ICU so noisy?

Almost all of the pumps and machines in the ICU have alarms, and you are almost certain to hear at least one go off during your visit. When an alarm goes off, it does not mean that the machine has stopped working, it simply tells the nurse that something needs attention or something about the patient has changed slightly. Very few of the alarms require immediate action from the nurse, usually the nurse will just silence the alarm and continue with the task at hand. If you are concerned or interested, please ask the nurse about the alarms.

 

When are patients discharged from intensive care?

The majority of patients who are admitted to the John Farman ICU are discharged as soon as their condition improves sufficiently to other wards in the hospital. This is important for the patient.

Being on ICU is not the best environment for a conscious patient who no longer needs the critical care monitoring. It is noisy all day and night, and can be alarming for a disorientated patient who needs a more 'normal' environment in which to recover. For some, this might take only one or two days…for others this can take weeks.

 

How long will it take to recover on the ward?

Once on the ward, the recovery process continues. How long this takes depends on the patient and their disease condition. The longer someone has been in intensive care, the longer it will take them to recover. In general, this process will occur more slowly in the elderly.

 

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After Discharge from the ICU

 

What to expect having left the ICU

You might have been admitted to the intensive care unit (ICU) as a result of serious illness or injury. Recovery from such illness is often slow, and even when you are physically more fit, it can take some while to return to a normal life.

 

When you first return or are moved to a ward, you have taken a big step towards getting better and going home. You and your visitors may, however, feel apprehensive about leaving the intensive care unit. This is quite normal for all hospitals, and we take steps to make the transition easier. The daily routines and staff in ICU have become familiar to you and your visitors. Now you all have to get used to new faces and different routines.

 

You will find the ward is very different to being in intensive care. The most obvious difference is that there are fewer nurses looking after a much larger number of patients, and the doctors are not there all the time. The fact you have been discharged from ICU means you are considered by your doctors to no longer need such close observation, and that you are able to do more for yourself.

 

If nurses do not immediately come to you, it does not mean you are being ignored. The nurses will always be close at hand and can be called using the bell by the bed.

 

To ease the transition between ICU and the general wards, Dr Park, one of the ICU consultants, visits all the recently discharged patients twice per week, just to make sure that everything is going well.

If you are concerned about the level of care you are receiving, discuss this the ward staff, to Dr Park or the Patient Advice and Liaison Service (PALS).

 

> Patient Advice and Liaison Service (PALS)

 

When will I feel better and have more energy?

In the first few days and weeks after a period in ICU, it is normal to find the slightest activity leaves you feeling tired. This is normal after a period of severe illness and will improve. How quickly depends on such things as your age, previous health, how ill you have been and for how long.

 

Why am I thinner and weaker?

While you were ill in ICU, you will have lost some weight, which means your muscles will have got weaker. If you have been immobile for some time, your joints can be stiff. To help you recover muscle strength, physiotherapists will help you with exercises to restore your mobility. Unless there are other medical and surgical reasons, you should be able to recover your muscle strength over a period of weeks and months.

 

Why have I lost my appetite?

When you were in the ICU, food will have most probably been given to you in the form of a liquid containing essential nutrients, via a tube into your stomach or by drip. Since you have been ill, you might find you have lost your appetite or that you no longer enjoy food because your sense of taste has changed. These changes are temporary and common but might take some weeks to return to normal. Just being in hospital and being worried is enough for many people to lose their appetite.

If you have a poor appetite, small meals with nourishing snacks in-between are often easier to manage than large meals. Some people find that fresh fruit or boiled sweets leave a more pleasant taste in the mouth. This is also a good time for visitors to 'spoil' you with little treats of your favourite foods – but do ask the nursing staff first to check that they are OK.

 

Why am I having difficulty sleeping?

After you have been in ICU, it is not uncommon to find your sleep patterns have changed. You might have difficulty falling asleep at night, or wake at frequent intervals during the night.

Your natural sleep patterns were disrupted while you were ill and they can take some time to settle down again. Being on a noisy ward doesn't help. You might find that a portable tape recorder (and headphones) and some relaxing music can block out the noises and help you relax.

When you have left hospital, if you are having trouble sleeping, try taking a bath or shower at bedtime to help you feel relaxed. It is a good idea to avoid drinking tea, coffee or large amounts of alcohol because these can disrupt your sleep pattern further. Try to get back to a regular sleeping routine, even if you need to have naps in the afternoon.

 

Why am I having bad dreams?

A common problem for patients who have been in ICU is having bad dreams (sometimes even while you are awake). Some people experience these when they are still on the ICU, others get them when they first leave ICU or even after they have gone home. They can be very vivid and frightening and some people complain of flashbacks or even hallucinations when they are awake during the day. These will subside over time. If you are having problems with them, do talk to your general practitioner about them. If you are having hallucinations, it can help to have someone with you to convince you that everything is OK and that they will pass.

 

Why does my voice sound funny now?

When you were staying in the ICU you might have had some difficulties communicating if you had a breathing tube (an endotracheal tube, or a tracheostomy). When this was removed, your voice might have sounded hoarse or weak. This should eventually return to normal, although it can take several weeks.

 

Why is my memory bad – I feel so scatty?

After a stay in ICU and when you first start recovering, you might find that you are more forgetful. This is not unusual, sometimes this is caused by the sedative drugs that you were given when you were very unwell. It can also be caused by anxiety and lack of sleep. All the ward and ICU staff, and your family and friends, will be happy to keep reminding you of important things and helping you to take information in.

 

I can't remember what it was like on ICU – I just remember odd things...

Sometimes a visit to the ICU when you are more able, helps make sense of what happened on the ICU and resolve some of the bad dreams.

 

Can I visit the ICU when I feel able?

When you feel more able, you might wish to visit the ICU and the staff who cared for you. We would be pleased to see you; it is nice for us to see people 'recovered' when we last saw them so ill. A visit can give you a clearer idea of the ICU. You might not remember the ICU much, because you have been very unwell.

If possible, ring and speak to the nurse in charge of the ICU, who can give you advice on when to visit. Nursing staff can be reached by telephoning 01223 217 474. However, if you are unable to ring beforehand, we would be delighted to see you at anytime, although the ICU might be quite busy.

 

What equipment was around me in ICU?

While you were in ICU, we monitored your well-being using lots of specialised machines connected to you by various tubes and cables.

 

What was all the noise in ICU?

The noise levels in an ICU can vary, but it can be quite noisy, especially during the day. Some of the intensive care machines make beeping noises and the occasional alarm will sound. This is normal and does not necessarily mean that something is wrong. The alarms just remind us that we will need to do something soon, or that the readings on the monitor have changed slightly.

 

Were staff talking about me while I was in ICU?

In addition to the sounds of the machines, you will also have heard the ICU team discussing your care, this might have been the nursing staff 'handing over' from one shift to another, or the medical staff looking at your progress. Communication like this is important to ensure that each team member can give you the best possible care.

Occasionally, you might have heard staff just 'chatting' about themselves and their lives. As a team, we try to keep this to a minimum because it can irritate some anxious patients.

 

Who looked after me while I was in ICU?

A number of medical, nursing and other healthcare professionals looked after you while you were in ICU.

 

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For people who have been ICU patients

 

Where can I get help after ICU?

The staff in the ICU will be happy to answer questions about your stay when you have left hosptial. There are many organisations available to provide help for those who care for people who have been seriously ill.

 

Will I need further intensive care later on?

Occasionally, some patients who have been on the ward deteriorate again, and need to be re-admitted to intensive care. This does not mean that they were discharged too early from the ICU.

 

 

 

 

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