For Patients and Families

Intensive care medicine involves the assessment, stabilisation, monitoring and ongoing care of patients who require special observation and support or are critically ill. Many hospitals, though not all, have an intensive care unit (ICU) which is a ward where patients who are very sick are provided with a higher level of medical care and observation than other areas in the hospital can provide.

Patients can be admitted after major surgery, after a traumatic event or even in an emergency because they are very sick and have an illness or an injury that is very serious. The doctors and nurses in the ICU are highly skilled and will closely monitor each patient.

If a family member or a friend has been admitted to ICU, they need special help and attention. The length of stay for patients in ICU will vary depending on their illness and this may be for a couple of hours to several months. However, most patients usually stay less than a week.

The ICU specialist may be able to give you a rough estimate of how much time the patient will spend in the ICU, the hospital ward after ICU and in rehabilitation.

For more information, visit: The Australian & New Zealand Intensive Care Foundation 

ICUs look very different to a regular ward in the hospital, there are many machines and monitors, some of them beeping, and more staff than you would normally expect to see. Some patients are unconscious or unable to talk so being in ICU either as a patient or visitor can be overwhelming. 

When you first see your loved one in the ICU it may come as a shock as they may be heavily sedated and connected to tubes and machines. They may not even look like themselves at all.

It is common for patients to be on a breathing machine called a ventilator, which could cause the patient to cough, which is normal. Patients can also sometimes display behaviours that are out of character because of their medication or illness. Sometimes staff may ask you to leave the bedside, and this could be because they need to perform a procedure that requires room around the bed, for patient privacy, or the procedure may be confronting for a loved one to see.

Intensive care specialists (Intensivists) are the specialist doctors who look after patients in an ICU. They have already completed their basic medical degree and have also completed additional training to learn the specific skills needed to work in an ICU.

Specialists who have completed the College of Intensive Care Medicine (CICM) training program have studied for at least six more years after medical school to learn how to look after very ill patients in ICU.

These doctors undergo a rigorous training and certification program as determined by CICM. Intensivists handle assessing, transporting and coordinating all aspects of the care of critically ill patients in the ICU.

There is usually an ICU consultant leading a team of doctors who examine patients daily to assess their progress and decide all aspects of treatment and care. In addition to doctors and nurses, there are many people who work in the ICU including physiotherapists, dieticians, speech therapists and other support staff. ICUs may also have a psychosocial support team available to you like Social Workers, Spiritual Care Workers, and Aboriginal Health Liaison Officers.

Because ICUs operate around the clock, the ICU specialists, registrars and nurses will be rostered to work on different days which means you will not always speak to the same staff member. Rest assured that ICUs have detailed handovers so that accurate information is transferred from one staff member to the next.

As a friend or relative of a patient in ICU, it is normal to feel anxious, and it can be overwhelming to see someone you love so ill. The ICU staff are there to answer your questions, so you should not be afraid to ask questions. It is advisable, however, to have one family member who is the main contact for the doctors and nurses to communicate information with. This allows the staff to concentrate on caring for your loved one while ensuring the correct information is being given.

There may be nothing for you to do but be present and connected to your loved one, which is a positive contribution. Research has shown that patients show positive effects including reduced blood pressure and heart rate when visited by a loved one. Simply sitting by the patient’s bed and holding their hand or staying connected by telephone will give the patient and yourself much comfort.

Just hearing your voice can be helpful. Keeping up a one-sided conversation can be difficult, but talking about happy memories and good times can also make you feel better too. You could also try reading a book or newspaper to them. However, too many visitors who stay visiting for extended periods with lots of stimulation are not beneficial for the patient during this critical phase of their illness.

This is especially important for patients with brain injuries. Rest is as much a part of the patient’s treatment as any of the medical treatments. It is important that you ask about the most appropriate visiting strategy for your loved one. This strategy may change as the patient’s condition improves.

The College is the organisation responsible for providing training in intensive care medicine. Following the completion of a basic medical degree and some time working in a hospital, doctors will join the College to undertake an additional six years (or more) of training to become fully qualified and specialise in intensive care medicine. The College is the sole provider of this intensive care medicine qualification in Australia and Aotearoa New Zealand.

The CICM has two main purposes. Firstly, we train doctors to become intensive care medicine specialists. Not only do we set the standard for the level of training which must be completed, we also set ICU standards for which doctors are trained. The College ensures that all trainees receive the same high level of training.

The College also has a role in communicating with other relevant organisations including government, medical councils, and other medical professional bodies and professional membership organisations to promote the maintenance of excellence in intensive care training and practice.

CICM utilises community experiences and feedback to inform the work of the College. CICM does this through its Community Advisory Committee and seeks the views of its Community Representatives when progressing relevant policies and projects.

Learning in intensive care medicine does not end once a doctor has graduated from the training program. Fellows of the College (specialist intensivists) must continuously learn and ensure their medical skills are always up to date, and this is called Continuing Professional Development (CPD). Fellows must take part in a CPD program which involves attending courses or workshops, reading the latest medical research, or visiting other ICUs to enhance their knowledge. 

CICM recognises the inequities in health outcomes for Indigenous peoples in Australia and Aotearoa New Zealand.

CICM is committed to ensuring Māori, Aboriginal and Torres Strait Islander peoples have fair access to intensive care medicine and receive health services within intensive care units delivered by intensive care specialists who are knowledgeable and skilled in cultural competency and safety. 

It is normal to feel a range of emotions when you have been to ICU, or a loved one is in ICU, support is available.

Support within the hospital

• If you need help dealing with personal or family problems, speak to a hospital social worker. They can offer advice on a wide range of issues, including financial matters, getting help, accommodation, carer support, transport, discharge services, counselling and bereavement and transition from hospital to home.
• A patient liaison officer can help with any issues you might have within the hospital. It is their job to make sure the rights and interests of patients is met. This includes helping patients, their families and staff and management to resolve any issues or complaints. Aboriginal Liaison Officers (ALOs) provide support to Aboriginal and Torres Strait Islander patients and families.
• If English is your second language or there may be communication issues due to a disability, most major hospitals will be able to arrange an interpreter or language services.
• All hospitals have spiritual care workers to support patients and families with spiritual needs.

Support outside of the hospital

If you are feeling overwhelmed, worried or struggling, you can get help and information from a range of resources:

• Lifeline: 24-hour counselling: 13 11 14
• Beyond Blue: 1300 224 636
• Veterans counselling service: 1800 011 046
• Victims of crime 24 hours: 1800 000 055
• Amber Community (Road Incident Support): 1300 367 797
• Brain Link: 1800 677 579
• Grief Line: 1300 745 845 (toll-free)
• Kids Helpline: 1800 55 1800
• Parents Line: 13 2289
• Men's Line: 1300 78 99 78
• 13YARN: 13 92 76
• Carer Gateway: 1800 422 737
• Disability Advocacy Support Line 1800 643 787
• Older Peoples Advocacy Network: 1800 700 600
• Health Direct 1800 022 222