Leaving the critical care unit

Critical illness can have a lasting effect on patients, both physically and emotionally, so throughout their stay in the critical care unit, a patient will start to receive rehabilitation as soon as possible and as often as is needed.

Rehabilitation on the critical care unit

Rehabilitation is started as soon as possible to prevent unnecessary weakness and limit physical problems following critical illness.

All patients will be reviewed by the physiotherapists on the unit and receive chest physiotherapy to help clear secretions and make sure that the lungs are working as well as possible, whether the patient is breathing for themselves or having assistance from a ventilator.

During their stay in critical care the patient may have lost weight and muscle strength and feel extremely weak. Physiotherapists will also help them to build up their strength again and move towards independence. We will continue to help patients with their daily needs whilst encouraging them to do things for themselves.

Speech and language therapists assess patients who have problems speaking or swallowing, and help them communicate more easily. They can also advise on how to start eating and drinking safely.

Dietitians and nutritional specialists will support and advise on nutritional requirements and any special dietary needs.

Coming off medicines

As the patient starts to recover, we will reduce the medicines used to make them sleep and keep them free from pain. As the medicines wear off, patients can become confused or agitated. This is a known side effect and we try to minimise confusion by explaining to the patient where he/she is and what is happening.

Sometimes, a patient’s recovery can be very slow and this can make them feel very tearful and frustrated with their progress. We will try to support the patient through this. Having supportive family and friends around them can help a patient’s recovery.

Leaving the critical care unit

When a patient no longer needs critical care treatment they will leave the unit, or be ‘discharged’ to another ward. This is usually a positive step, however, for some patients and relatives it can be difficult to adjust to no longer having one­-to­-one nursing.

A member of the critical care team will visit the patient a few days after discharge to check on their progress. The ward staff and physiotherapists will continue to support the patient to achieve their rehabilitation goals they are ready to go home.

The ICU steps website has lots of useful information about the physical and emotional effects of a prolonged critical care stay and what life may be like when patients leave critical care. Visit the ICU Steps website.

Critical Care follow up clinic

We run a follow up clinic for patients who have been critically ill. The clinic, which is run by Dr Gill Saville, provides our patients with the opportunity to discuss their stay and work through any problems they are experiencing in their recovery.

This has been shown to help with the recovery phase of critical illness and is vital in helping us improve the care of both patients and relatives on the critical care unit in the future.

Typically, any patient that has been on a ventilator for more than three days is invited to attend three months after discharge. Other patients who were not ventilated but received high dependency care and are still having problems with their recovery after four to six months can also be referred by their GP.