Some improving patients will first move from ICU to the high dependency area, to continue to keep a close eye on them and to ensure that their improvement is sustained.
In due course the patient can go back to the general ward appropriate to their needs, occasionally this will be a specialist area such as a spinal injuries unit or stroke unit. If the patient was transferred for specialist intensive care this is often the time they return to their base hospital to be nearer home.
The medical and nursing teams on the ward will get a thorough hand-over from the critical care team, and some hospitals have an outreach team consisting of ICU nurses who help patients, relatives and ward staff cope with the transition. The ICU team will try and prepare patients and families for ‘stepping down’ and viewing the more normal atmosphere of the general ward as an important step towards recovery and rehabilitation.
Hospitals aim for transfers to happen in daytime, when more staff are available to help with settling in, although this is not always possible. Families will always be informed that the patient has moved so they come to the correct place at visiting time.
Transfer back to the ward is a good thing as it means the patient no longer needs intensive care, but the transition to the general ward environment can be challenging for both patient and family, particularly if the critical stay has been prolonged. Although critical care is difficult, it offers security that a patient’s every change is noticed, and need provided for. It is, however, not somewhere to stay if critical care is no longer required.
On the ward, with less nursing and medical staff immediately to hand, patients and families can feel abandoned and anxious about a deterioration in the patient’s condition. This is normal and gets better in time as the patient continues to improve.
Critical care areas are keen to ensure that patients and relatives get the best care during their stay and many offer a feedback questionnaire on their experiences.
Please take the time to complete one if it is available as they are vital for improving the service.