Your time in ICU
When you've been critically ill and you have been asleep for long periods because you were unconscious or sedated, you may have difficulty remembering what happened to you. Also, you may have had vivid dreams, nightmares or hallucinations which upset you.
You may even believe that staff were trying to hurt you, because of the treatments you were given to make you better. These things are normal for someone who has been critically ill and can be caused by the illness or the drugs used to treat it. You may find it difficult, but it can help to talk to someone you trust about this and it really is nothing to be ashamed or embarrassed about.
Below is some information about some of the things that happen in an intensive care unit. It may help you make sense of things you remember.
Staff in the intensive care unit (ICU)
There are many different people who work and help out in the ICU. Doctors in the ICU are usually also anaesthetists, so they are specially trained to give you pain relief and advice. As well as the nurses, you may also see speech therapists, physiotherapists, dieticians (specialists in food and nutrition) and other support staff on the unit.
You are likely to meet a lot of these people, but you may only remember a few names and faces.
In an ICU there will usually be a consultant who leads a team of doctors. The consultant and their team usually go around the unit each day to check on each patient and make decisions about their treatment and care. There may be other staff with them, and you may remember them examining you or hearing them discussing your treatment. The doctors and their team may spend time with you each day to see how you are getting on. They may examine you, listen to your lungs with a stethoscope and look at any wounds you may have, in order to plan your treatment and care. Doctors who are specialists in other areas may also visit you. They may be medical, surgical or orthopaedic doctors, who you saw before you were admitted to the unit. They will look after you again once you are well enough to be looked after on a general ward.
In an ICU, one nurse will usually look after one, or at most, two patients. Your nurse will be responsible for providing most of the care you need and, in the early stages, will spend most of their time at your bedside. They will also work with other professionals, such as doctors or physiotherapists, to make sure you receive the correct treatment and care when you need it.
The nurses will do things for you that you can't do yourself, including the following.
- Taking regular blood tests
- Changing your treatment in line with your test results
- Giving you the drugs and fluids that the doctors have prescribed
- Recording your blood pressure, heart rate and oxygen levels
- Clearing fluid and mucus from your chest using a suction tube
- Turning you in your bed every few hours to prevent you getting sores on your skin
- Cleaning your teeth and moistening your mouth with a wet sponge
- Washing you in bed
- Changing your sheets
- Changing your surgical stockings, which may be used to help your circulation when you are inactive (lying still) for a long time
- Putting drops in your eyes to make it easier for you to blink
During your stay in intensive care, you will be seen and treated by a physiotherapist. They will try to make sure your lungs are kept clear by carrying out physiotherapy on your chest. They will also exercise your arms and legs when you are asleep to work your muscles and to stop your joints becoming stiff. If you were ventilated (connected to a machine to help you breathe) in the ICU, the physiotherapist will give you exercises to help strengthen your lungs and breathing muscles so you can breathe without the machine as you get better. This will reduce the chances of you getting a lung infection.
As you get better, physiotherapists also help you with exercises to get you strong enough to get out of bed. When you're ready, they will help you get up and moving about again.
A dietician will visit you to work out your nutritional needs and how you will be fed. You may be fed through a nasogastric tube (a tube that goes up your nose and down into your stomach) or, if you cannot have food in your stomach, you may be fed through a drip straight into your vein.
A speech therapist may also visit you, especially if you have a tracheostomy. (A tracheostomy is a procedure to make a hole in your throat and insert a tube, which is connected to a ventilator or 'breathing machine'.)
The speech therapist may see later if you can have a speaking valve on the tracheostomy. They will also monitor you to see if you can swallow well enough to start to drink and eat normally.
Planning for your recovery
After being critically ill, it may take you several months to recover. The staff may carry out health checks to find any likely physical or psychological problems you may face because of your illness. If they think you are at risk of having problems later in your recovery, they may carry out more checks:
- before you leave the ICU;
- before you're discharged from hospital; and
- after you've been out of the ICU for two to three months.
Depending on the results of these checks, the intensive care staff may prepare a rehabilitation plan for you. What is in this plan will depend on how long you were in intensive care and your needs, but may include information on:
- the difference between intensive care and ward-based care;
- the physical, dietary or medical needs you are likely to have in the future; and
- who will be responsible for your care when you are in the hospital and when you leave.