The healthcare team visits all patients in the ICU each day. They talk to the patient and their family members and friends about how things are going. They also make decisions about treatment and plan care for the day. This is called patient care rounds.
You and your family
You and your family are key members of your healthcare team. Whenever possible you’ll be included in the care and treatment decisions during your stay in the ICU. Many hospital rooms, including some ICUs, have white boards on the wall with key information for you. On the whiteboard you’ll find the date, the name of your nurse, doctor, and a list of treatments or plans for the day. You or your family are welcome to take part and ask questions during rounds to get a better understanding of your choices for care and treatment. On the whiteboard there’s a space for you to write questions. Usually these are answered during rounds.
Doctors and Nurse Practitioners
In the ICU you’ll have a doctor who is a specialist in intensive care (called an intensivist). This intensivist leads the team of healthcare professionals looking after you while you are critically ill.
The intensivist may have other doctors with them like residents, staff, and students, who also have a role in taking care of you. They may each examine or assess you. Other doctors who are specialists in other areas may also come to see you in the ICU. This can include surgeons, cardiologists, and others. These other specialists may also look after you once you’re well enough to go to another area of the hospital.
Some ICUs have nurse practitioners who assist the intensivist in leading the healthcare team. As the medical team changes over the course of your stay nurse practitioners can provide a consistent link to the care team.
The intensive care doctors and/or nurse practitioner may hold family conferences when needed to give medical updates to you and your family. It’s important to write down questions you have so you can ask them at these meetings. The patient rounds are often quick and you may not have enough time for all your questions. The family conference is a good time to get a clear update and get all of the information you need. If you’d like to have a family conference, let your nurse know and one will be arranged at a time that works for you and the doctor or nurse practitioner.
In the ICU usually 1 nurse will look after 1 or 2 patients depending how ill they are. The nurses provide support and reassurance to you and your family. They assess, monitor, adjust treatments, and report your condition to the rest of the healthcare team. Nurses provide basic personal care and often many of the more complex care and treatments that you may need while in the ICU. This includes dressing changes and wound care, monitoring your vital signs (blood pressure, heart rate and rhythm, and oxygen levels), checking your lab test results, and managing your pain. They also work with other professionals to make sure you receive the correct treatment and care when you need it.
Talk to the charge nurse or unit manager if you need more information. The charge nurse and unit manager help manage the ICU, and will be able to offer additional support.
During your stay in the ICU a physiotherapist (PT) may come to see and work with you. Getting you moving as early as possible (called early mobilization) will help you recover more quickly and lower the risks of side effects from your critical illness. If you’re on a breathing machine (ventilator) or can’t get up because of your condition, the physiotherapist will help with exercises to keep your strength up as much as possible. Your lungs and breathing muscles need to get strong enough so that you can breathe without the machine. Your arms and legs need to stay strong so you can get up as soon as you are well enough. If there isn’t a physiotherapist in your ICU the nurses will help you with these.
As you get better, your physiotherapist or nurse will help you exercise so you can get strong enough to get out of bed and move on your own. If you need a walker or crutches to get moving again, your physiotherapist can help organize getting the right equipment while you’re in hospital and getting ready to go home.
A respiratory therapist (RT) will come see you in the ICU if you have trouble breathing, need oxygen, or are having a problem with your lungs. The RT may also put in a special line into an artery in your wrist to help monitor your blood pressure. This is called an
arterial line. From this line they can take blood samples to measure your oxygen levels and do other blood tests.
If you need to go home with any respiratory equipment, the RT will teach you what you’ll need to do at home.
Many ICUs have a clinical pharmacist that works with the team in looking after you. The pharmacist recommends drug therapy and researches specific drug information questions to help with your care.
The pharmacist will check on all the medicines you’re on at home. This includes prescription, over-the-counter, and herbal medicines you may have been taking. This helps them watch for drug interactions and see what you need to be keep taking while you’re in the hospital and what you’ll need when you go home.
A dietitian may visit you if you can’t eat like usual. They’ll help decide what nutrition you need and how you’ll be fed. Sometimes it’s through a feeding tube, which is a tube that goes into the nose or mouth and down into the stomach. If you can’t have food in your stomach you may be fed through a drip straight into a vein. You will be allowed to eat normally as soon as it is safe to do so.
If the ICU you’re in has an occupational therapist (OT) they may come see you to see how well you can do your basic activities of daily living. These include bathing, dressing, eating, and getting to the bathroom.
An OT may also help with ways to prevent
pressure sores. They may suggest a special type of bed or chair cushion. An OT can help with things like splints to keep fingers form curling up if you can’t move, or a neck collar if you’ve had an injury or need neck support. An OT can also help you with exercises to help get stronger and teach you ways of doing everyday tasks so you don’t hurt yourself. They can help you become more independent.
Speech Language Pathologist
If you’ve had a stroke, are having any trouble swallowing, or have a
tracheostomy (a hole in the throat for a breathing tube), a speech language pathologist may be asked to see you. They’ll check your speaking and swallowing and make suggestions about if it’s safe for you to eat or drink. The swallowing tests may be done at the bedside with different consistencies of food. You may also need a study using X-rays to watch how you swallow.
There are many others who make up the healthcare team. These are available in most ICUs in Alberta. These include:
- social workers – can assist with financial resources
- indigenous coordinators – help indigenous patients and families with any cultural needs
- diagnostic imaging technicians – perform diagnostic tests like X-rays
- transition coordinators – can help you plan for your care in the community once you leave the ICU
- chaplains or spiritual care – help with your spiritual health and well-being (You and your family don’t have to belong to a religion to be supported by spiritual care. They are available to talk with you and listen to anything you want to talk about including your fears and concerns.)