The Intensive Care Units (ICU), also known as Critical Care Units, are specially staffed, equipped and designed to closely monitor and treat patients with life-threatening conditions.
Patients may need specialist treatment because one or more of their body systems, such as their heart, lung or kidneys, are not working properly. Admission to the ICU may be pre-planned, for example for close monitoring following major surgery or unplanned, for example following a car accident, trauma or deterioration in a patient’s condition.
There is an Intensive Care Unit at both Maidstone and Tunbridge Wells hospitals caring for intensive care and high dependency patients. ICU patients need support for more than one body system after sudden illness or major surgery while HDU patients need close monitoring, but do not need a machine to help them to breathe – usually they only need one system to be supported by drugs or a machine.
The Intensive Care Units of Maidstone and Tunbridge Wells work closely together to provide the best patient care and patients may need to be transferred across sites to access specialist services.
Tunbridge Wells Hospital – telephone 01892 635598/635446
Maidstone Hospital – Unit A – telephone 01622 222025 or 01622 222028 Unit B – telephone 01622 224398 or 01622 224401
Due to the severity of our patients’ illnesses we offer relatives and friends as much flexibility as possible with visiting times and try to tailor this to each patient’s needs. We recommend that only family and close friends visit. Due to limited space and the need to allow staff to work around you, we generally restrict visitors to two by the bedside at a time. Please note that fresh flowers are not permitted in the ICU.
Preparing to visit
It is important to know what to expect during your visit. Your relative/friend may be attached to several drips, drains and pieces of specialist equipment. This is quite usual within the ICU, but may be a shock, so please feel free to discuss your feelings and questions with staff.
The daily routines in ICU are different from other wards because it is a specialist and complex department. There is a high level of activity all day and night and noise levels are likely to be greater because of the operation of equipment, often beeping or sounding an alarm. An alarm doesn’t necessarily mean something is wrong, just that there is something that staff need to be aware of. Staff will be able to explain the equipment and noises to you.
ICU patients often become swollen around the face and limbs. This is quite common when someone is critically ill and is caused by their inability to move, the treatments for blood pressure, and having a machine controlling their breathing. The nurses may try to reduce the effect by keeping the head of the bed slightly raised and the patient’s hands raised on pillows. The swelling usually reduces gradually as the patient gets better. Rings may need to be removed to protect the blood flow to the fingertips.
How might ICU affect the patient?
No two experiences of ICU are the same. However, for many patients this is a very stressful time. As a patient wakes up they may feel confused about where they are and what has happened, and may be anxious as a result. Sedation and medication can be used to relieve this, but sedation can make it difficult for a patient to think clearly. Sometimes the combination of medication and being so unwell can change their understanding of what is happening and they may seem angry, hostile, or just different.
Patients who need a machine to support their breathing will not be able to talk, which can be frustrating for them. However, it is important that visitors talk to the patient and, where appropriate, hold their hand. Sedated patients will often recognise a relative or friend by touch or the sound of their voice and be reassured by their presence.
Sedation can leave patients with a gap in their memory of that time. Some patients and visitors find it helpful to keep a diary of the patient’s stay in ICU.
Hallucinations, delusions and nightmares
Patients who are sedated while in ITU vary in how much they remember of their stay, but most can recall the days immediately after the removal of their breathing tube, although this may be fragmented. Patients often have detailed memories of “un-real experiences” involving particular objects, nurses and emotions. Discussing these memories later on often reveals that they are based on a misinterpretation of events happening around the patient at the time. The memory may be frightening, pleasant or simply peculiar and “unreal”. Please don’t be afraid to discuss these experiences with the nurses. Rarely these may recur after recovery. Patients who develop issues with sleeping or hallucinations after returning home should please contact their GP for help or advice.
Feeling weak and loss of weight
ICU patients may lose weight and muscle tone whilst critically ill. Joints may stiffen due to the long time spent in bed and there may be some loss of sensitivity in the fingers and other small joints. This can be distressing but, as patients grow more active, muscle weakness and joint stiffness will improve.
All ICU patients have physiotherapy, which helps to build physical strength and aids the rehabilitation process. While patients are recovering they often feel anxious and depressed about the effects of having been critically ill. We encourage patients to discuss these feelings with their relatives and with staff.
The ICU day
All patients are seen on admission and then at least twice per day by the Intensive Care Consultant. This is an experienced clinician who has had specialist training in caring for the critically ill. Patients also remain under the care of the specialist consultant who admitted them. There is a resident doctor who is experienced in care of critically ill patients on duty on the units at all times. A ward round is conducted every morning where the plan for the day is decided. Visitors are usually asked to leave during this in order to ensure privacy for all patients on the units. Visitors will be kept up to date with the plan and progress of their relative.
All patients are seen at least daily by the physiotherapists, dieticians and other specialists as necessary. Patients on ICU often need regular chest x-rays, CT scans and other diagnostic tests. They also need a high level of nursing and medical interventions. Visitors may be asked to leave and wait in the waiting room while these are carried out.
For more information on our ICU units, read our patient information leaflet: