Discharge from the Intensive Care Unit to the ward

The transition between a critical care area and the ward can be a stressful time for you and your relatives. This document includes guidance and support which has been developed to help the transition from Intensive Care Unit to the ward and from the ward to home. It also identifies some common problems that you may experience when you leave Intensive Care.

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Recovery from critical illness

The transition between a critical care area and the ward can be a stressful time for you and your relatives. This document includes guidance and support which has been developed to help the transition from Intensive Care Unit to the ward and from the ward to home. It also identifies some common problems that you may experience when you leave Intensive Care.

Moving from the Critical Care Unit is a positive sign as it means that you are getting better. For some people, however, this can be an anxious time. After you have been ill, especially for a long time, it can take a while to feel yourself again and there may be long term or lasting effects depending on how unwell you were and the type of illness you had. On the ward, you will notice that there are fewer nursing staff, this is because the care dependency of the patients on the wards is much less than in critical care. You may feel very tired, however, you should find that you can do more for yourself. Starting off by small things such as washing your hands and face. Try to be positive; throughout the process you will gain strength and find you are able to do a little more each day.

It may take a day or so to adapt to the new environment; the nurses, doctors and physiotherapists are there to help and support you. Visiting hours may also vary from ward to ward.

Who are the critical care outreach team?

Prior to your admission to the Intensive Care Unit, you may have been reviewed by the Critical Care Outreach Team (CCOT). The CCOT are a team of Advanced Clinical Practitioners (ACPs) who support the ward areas with the care and care planning of unwell patients and those who may be at risk of becoming unwell. The CCOT operates 24/7 with a diverse range of critical care experience and skills. When discharged from ICU, the CCOT will visit you on the ward. They will review your general condition, monitor your progress and talk through any concerns you may have. This may be the last time you’ll routinely see members of the intensive care/critical care team. However, if you wish to speak to a member of the CCOT again while in hospital, please ask a member of staff to contact them on your behalf.

Rehabilitation

After you have been in intensive care for a while, you may find that you experience:

  • Muscle weakness and joint stiffness
  • Decreased exercise tolerance
  • Reduced sleep and vivid dreams
  • Feeling emotional and lacking in the ability to concentrate

Recovery time will vary from person to person. If appropriate, the physiotherapists will continue to see you in the ward area and support with the practice of breathing and physical exercises to improve mobility. Sitting out of bed each day (where possible) will be a focus to help to increase lung expansion.

Nutritional input

Weight loss, poor appetite, low energy, difficulty swallowing and taste changes are some common problems that can occur when recovering from critical illness. You may find you continue on a specialised diet or an enhanced recovery programme, take supplementary drinks or may not be able to consume nutrition orally. Our dieticians assess you as an individual and follow-up accordingly.

Follow-up clinic

In the months following ICU discharge, you may be invited to attend a follow-up clinic. The critical care follow-up clinic provides an opportunity for you (with your family or carers) to discuss your critical care experiences and the impact they may have had on your path of recovery. As a multi-disciplinary team led clinic, the clinic additionally allows for the opportunity for health and care staff to learn from patient and family experiences to improve future care. Please ask a member of the critical care team for more information regarding follow-up clinic invitation and attendance.

Further information

For further information on the support, please explore the following websites:

Healthtalk online

A website covering a variety of personal experiences of health and illness. It includes sections for critical care patients’ and their relatives.

www.healthtalkonline.org

ICU Steps

A registered charity run by ex-intensive care patients, relatives and ICU staff to support patients and families through the long road to recovery from critical illness.

www.ICUsteps.org.uk

Cancer Care

02072420300

www.cancerresearchuk.org

Steps2Change

A self-referral service to assist with mental health issues including anxiety, stress and PTSD.

www.lpft.nhs.uk/steps2change

TACC, Pilgrim Hospital
Telephone: 01205 446232

TACC, Lincoln County Hospital
Telephone:  01522 458629