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State of the Art 2017
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By the bedside
Involvement and visits from family and friends matter a great deal - read how you can support and be supported.
One of the most helpful things that friends and relatives can do is to visit a loved one. Most intensive care units do not have set visiting times but some ask relatives not to visit between specified times. This allows the patient to rest and the staff to perform vital care.
Most units limit the number of visitors allowed at the bedside at any one time. It is advisable to check with the nursing staff what the visiting times are.
Infection control in intensive care is extremely important because patients are very ill and therefore can pick up infection easily. It is essential that all visitors comply with local hygiene policies. The nursing staff can advise what you need to do.
Involvement in nursing care
Sometimes relatives and friends can feel that they are like ‘spare parts’; but they can help if they wish to by carrying out simple yet important tasks such as combing the patient’s hair or helping with giving sips of water.
The nurses will be happy to describe what tasks relatives and friends can do which will benefit the patient and assist in support and comfort during what can be a difficult time for both.
One main contact per family
The intensive care team, as part of the patient’s treatment, will keep relatives informed of progress and of any difficulties being encountered.
The team will always do its best to answer your questions in a timely fashion, but at busy times there may be delay before a team member is available. It is always possible to make an appointment to see a senior team member. Experience has shown that ensuring all friends and family are aware of a loved ones' condition is best achieved by the family nominating one person as the contact point. This also helps to safeguard patients’ confidentiality.
Similarly it is helpful if relatives establish a number of main contacts within the medical team. This avoids the problem of receiving information from staff who may not be fully appraised of the patient’s condition.
Advances in medical knowledge and treatment have been brought about through research and the practice of medicine today is based on evidence of what works.
There are always a number of research trials being undertaken in intensive care units throughout the country into different aspects of medical care. All of these research trials are approved by an independent ethics committee of outside experts to make sure patients’ best interests are protected.
Patients are often too ill to give their own consent to enter a study. It is therefore very common for a close family member to be asked to act on the patient’s behalf and help decide if the patient would wish to take part in the research. Taking part is entirely voluntary and no one is under any 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.
When the patient is in hospital, their condition and treatment must remain strictly confidential between them and the staff looking after them. Any information about the patient will not be disclosed to anyone unless that person has been named by the patient.
Occasionally, particularly in emergency admissions, the patient will be unconscious and information about the patient which is vital to their treatment will be required from the relative or next of kin. In such instances the relative or next of kin will be kept informed of treatment and progress but the staff will not disclose any of that information to any one else.
Sadly, in spite of all the efforts of the staff and medical knowledge, some patients will deteriorate and die. This will rarely be a sudden and unexpected event and the doctors and nurses will have time to discuss the patient’s deterioration and likely consequences with relatives.
Doctors and nurses will do all they can to ease the burden
Bereavement will be a sad time and the doctors and nurses will do all they can to prepare relatives and ease the burden. Religious support is always available to those who wish it.
Organ and tissue donation
Organ and tissue donation is the gift of organs or tissues donated after death to help someone who needs a transplant. Hospital staff are committed to doing everything possible to save lives, and organ and tissue donation is only considered after all attempts to save life have failed.
When people die in intensive care it may be possible for them to donate organs and tissues. Many people have made decisions in their lifetime about donation and it is important for the hospital staff caring for your relative or friend to find out what these wishes are.
To be able to explore if a patient had expressed a wish to donate, hospital staff will always check the organ donor register and ensure that they discuss organ and/or tissue donation with you as the patient’s relatives or friends.
You will be offered the option of discussing organ and/or tissue donation with a donor co-ordinator who will be able to answer any questions that you may have.
All hospitals have multi faith support and the staff will be happy to arrange for the appropriate person to be contacted should the patient or relative or friend want to discuss any issue.