Preparing for an admission to critical care

We appreciate that planning to have major surgery is a worrying time. You have been given lots of information about various aspects of the treatment and care you are likely to receive. Your medical team are planning to admit you to critical care immediately after your surgery and this alone can be a stressful time. This leaflet aims to give you simple information to support you in the preparation for your surgery and recovery.

There are two main critical care areas in the hospital:

• Neurosciences Critical Care Unit (NCCU) is located on A2/A3
• John Farman Intensive Care Unit (JVF ICU) is located on D3/D4

Each area has its own speciality and you will be admitted to the appropriate unit depending on the surgery you are due to have.

Why critical care?

Your surgeons would like you to come to critical care because they anticipate that you may require constant monitoring and treatment during your initial post-operative phase. This is often routine for many major operations. Patients who have a planned admission to critical care are often unaware of their transfer to the unit as they remain under general anaesthetic at this time. They are given a period of time to rest and then woken up slowly and in a controlled manner when appropriate. This can take anything from a few hours to several days.

Who will be looking after me?

You will be looked after by a team of highly skilled critical care staff including doctors, nurses, physiotherapists, pharmacists, dieticians, occupational therapists, speech and language therapists and psychologists. It is likely that you will be surrounded by a lot of equipment and monitoring devices which can appear quite overwhelming and noisy but is quite normal in a critical care unit. The team will gladly explain the use of any equipment if you would like to know more about it.

Delirium

It is common for patients in critical care to experience a period of delirium which is usually temporary. Delirium is a name for acute confusion and is sometimes described as like being in a nightmare, but it feels very real. A patient with delirium is hallucinating, which means they can see, hear, or feel things that don’t exist outside their mind. They may imagine they are in different situations, which can be frightening. Often the patient is convinced that what they are experiencing in their mind is actually happening which may be distressing for them and very worrying for relatives.

Critical care staff are very experienced at supporting patients through delirium and will have many ways to help both patients and their relatives.

Will I be in pain?

You will have medication to help with pain given through the intravenous lines (the small plastic tubes that are put into your body and attached to infusion pumps). You will be closely monitored for signs of pain so that it can be addressed quickly.

Privacy and dignity

Cambridge University Hospital (Addenbrooke’s) is committed to treating all patients with privacy and dignity in a safe, clean and comfortable environment. During the time when you require critical care with the use of specialised equipment you may not be cared for in a same-sex bay. However, staff will always do their best to respect your privacy and dignity at all times.

Visitors in critical care

All patients in critical care are allowed visitors. We ask that they follow current Trust guidelines and respect our infection control procedures. Your relative will also be able to contact the unit via telephone to receive updates on your condition and even speak to you in person when you feel able to talk.

Leaving critical care

Often patients will stay in critical care for longer than originally planned and the reasons for this will be discussed with you and your relatives at the time. You will be transferred to an appropriate ward when you no longer require invasive support for your breathing and following a thorough review when the critical care team and your surgeons consider you well enough. This is an important step forward in your recovery but can be daunting as you will receive less medical and nursing intervention in a ward area. It is understandable that you may feel anxious about this step and you may find it useful to speak to your nurse at the time.

Recovery from critical care

Our Clinical Nurse Specialist team will continue to offer holistic support with regards to your critical care recovery on the ward. Once you have been discharged from hospital they are also available for support via the phone and our outpatient face-to-face follow up clinic. It is common for the recovery process to feel like a rollercoaster, the journey will take time, often months with both good and bad days. It is common for patients to experience some or all of the following:

• Muscle weakness, joint problems, excessive tiredness
• Unpleasant memories of being on Intensive Care
• Anxiety, flashbacks or nightmares
• Inability to regain weight or eat properly
• Questions about what happened

The critical care clinical nurse specialist team can talk to you about any of these

issues. They can make onward specialist referrals if required. They would also be happy

to discuss any concerns you may have related specifically to critical care prior to your

surgery. Please do not hesitate to contact the team using the contact details below.

Critical Care Clinical Nurse Specialists

Email the critical care CNS's

Team phone: 07874637348

You may also be interested in finding out additional information from ‘ICU Steps (opens in a new tab)’ which is the intensive care patient support charity. There are multiple leaflets available on this website which may interest you before and after your admission. criticalcarerecovery.com is also another very useful website for patients and relatives before, during and after a critical care admission.