It starts with the shock that someone you love is sick enough to be here. The sight of your parent, partner or child under harsh lights, possibly bandaged and bruised, attached to tubes, drains, IV lines, maybe even a ventilator. The unfamiliar sounds of beeps, buzzes and emotional outbursts from nearby rooms mixed with rare periods of somber silence. Fast-moving staff in a blur of stethoscopes, scrubs and rapid-fire exchanges of incomprehensible medical terminology. You’re in the intensive care unit — so how do you cope and best support the patient at the center of it all?
Buckle Up
For patients and families alike, hospital ICU stays resemble roller coaster rides, with sharp peaks and plunges, bad days and better days. “Stimulation overload” is how critical care nurse Kati Kleber describes the introduction to the fast-paced ICU environment. High-tech noises and bedside procedures are just part of the picture for overwhelmed family members.
“They’re learning all these new things from the physician and nurses and meeting them for the first time,” says Kleber, who works in the Charlotte, North Carolina, area. “So it’s really like getting slapped in the face with information, and it’s all kind of scary because it’s your loved one.”
Why Intensive Care?
The sickest patients in the hospital are those in the ICU, where the staff is equipped to take care of people with conditions including strokes, heart attacks, major respiratory problems and surgical complications. Trauma from car crashes, gunshot wounds, severe falls, accidents and fires can also put patients in the ICU.
Round-the-clock bedside monitoring by critical care nurses — which isn’t possible in a regular hospital unit — is a hallmark of ICU care. “Most intensive care units have nurses with one or two patients,” says Kleber, the author of “Admit One: What You Must Know When Going to the Hospital, But No One Actually Tells You.” That compares to six or so patients per nurse in non-critical care units.
Having fewer patients allows ICU nurses to work with complex patients on powerful medications, manage medical equipment like ventilators, continually track vital signs and critical body functions, and treat the pain and discomfort so many patients experience.
[See: 14 Things You Didn’t Know About Nurses.]
Can I Touch?
Kleber often hears, “Is it OK if I give him a hug?” from family members who are understandably anxious they might dislodge some vital medical device. Most of the time, she says, the answer is “Of course you can.”
“Can I sit on the bed?” is another common question. Because the bed is often zero-balanced to the patient’s weight and will set of an alarm with the added weight of another person, the nurse may need to adjust it first. “I’m happy when people ask,” she says. Sometimes, she explains, even moving the head of the bed up or down could affect monitor lines, which are calibrated to the patient’s position.
Meet the Team
As you start to get your bearings, the staff will become less of a blur and you’ll get a better sense of the ICU team taking care of your loved one. Critical care physicians, known as intensivists, specialize in diagnosing, treating and directing the care of ICU patients.
Similarly, critical care nurses have specialized training in this area. Nurses help guide families by explaining what’s going on with the patient’s care, giving updates on his or her condition, answering questions and providing support in this anxious and emotional time.
Other medical specialists — doctors such as cardiologists, nephrologists and endocrinologists — may be part of the treatment team, depending on the individual case. Respiratory therapists play a big role in the ICU, where many patients have compromised ability to breathe. Other clinicians like physical therapists work with patients to prevent long-term disability and maximize their ultimate recovery.
As a family member at the bedside, you can listen and learn a great deal about your loved one’s care and condition from a variety of perspectives. Many ICUs conduct regular interdisciplinary rounds. The intensivist, nurse, pharmacist, chaplain, dietitian and social worker are all included, and “the entire health team, which can get pretty big, comes around room by room,” Kleber says.
Give yourself a method to keep track of incoming information, whether it’s writing in a notebook or an online journal. Jot down status updates on your family member, treatment plans and goals, names of your ICU team members and their specialties, and questions you intend to ask and don’t want to forget.
[See: When Health Treatments Go From Hospital to DIY.]
Open Communication Lines
It’s wise to pick a family member to act as a point person for the ICU staff. That person, or another willing communicator, could reach out to keep extended family and friends in the loop. Isolation is the most challenging issue for family members thrust into the ICU, says Sona Mehring, founder and chief ambassador of CaringBridge, a nonprofit that hosts personal websites that allow people to share their health care journeys beyond the ICU walls.
“It’s an intensive care unit so it’s not a warm and fuzzy place,” Mehring notes. Finding any sense of control is important, she says. That could be reaching out to your primary nurse to build a rapport. Claiming your own space, even if it’s where you sit in the room, can provide a sense of comfort and control, she says.
Connecting to others outside the ICU helps them understand the situation and react to it, Mehring says. “When people get into a serious situation in the ICU, a lot of their friends will back away because they quote-unquote don’t want to bother them,” she says. “I believe the opposite is important. You need to lean in, ask what you can do to help; even little-bitty things. Letting them know, ‘we’re shoveling your sidewalks’ can relieve the stress of what’s happening within the ICU.”
[See: 14 Ways Caregivers Can Care for Themselves.]
Care for Yourself
A study from Emory University Hospital asked 45 family members of ICU patients about their own most important needs. The survey results, published in the March 2016 American Journal of Critical Care, found that top priorities were gathering information about the patient, visiting, being given hope, talking with a doctor daily and getting assurance that the patient was receiving the best care. Family members ranked their own physical comfort as least important.
Kleber sees this selfless devotion every day. She urges family members to give themselves a break, especially if she knows the patient is stable and likely to have an extended stay. “ICU is when the nurse is there constantly,” she reminds them. “So take the time to shower, get situated, eat some real food, run to the store and bring back snacks to have with you — because I’m going to be here all the time.”
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What to Expect When Your Loved One Is in the ICU originally appeared on usnews.com
