Critical Care Unit

The Critical Care Unit, also known as the Intensive Care Unit or ICU, provides advanced care for patients who require close monitoring due to the seriousness of their injury or illness, or due to the fact that their condition can change quickly. Care in the Critical Care Unit is provided by an interprofessional team of care providers, which is made up of specially trained healthcare professionals including intensivists (critical care doctors), nurses, and other care specialists. (For a full team listing and their roles, please see the "Critical Care Team" section below.) Each professional brings his or her particular expertise to the team, collaborating on a plan of care and treatment for each patient, based upon his or her individual needs and conditions. The role of the team is to provide the best care possible to the patient, to update the family spokesperson throughout the patient's care, and consult with the patient's designated next of kin about the patient's care if the patient is unable to do so.


Visiting and Hours

Visitors to the Critical Care Unit enter through the Family Waiting Room on Level 3 (View the map here). This is a locked unit, so visitors are asked to be buzzed in by picking up one of the phones near the door to the unit.

We understand that this can be a very difficult time for family and loved ones. We try to be as flexible and accommodating as possible for visitors, balancing the needs of the family with the needs of the patients – as well as respecting the needs of other patients in the unit. For those reasons, we ask that you:

  • Use the phone in the Family Waiting Room to call reception when you want to enter the Critical Care Unit
  • Have no more than two visitors at a time per patient
  • Turn off cell phones and other electronic devices
  • Please, no photography or videos including cell phones
  • Leave food, drinks, and gum outside of the Critical Care Unit
  • Please stay at home if you have symptoms of a communicable disease including fever, cough, and runny nose (patients in Critical Care are most vulnerable, and even a cold can cause serious complications)
  • Use hand sanitizer when entering and leaving the unit
  • Flowers and other scented gifts are also not permitted due to scent hypersensitivity
  • Wash off any scents such as perfume, cologne, and other body/hair products
  • Wear shoes at all times
  • Please feel free to ask questions (note: due to confidentiality issues, we can only discuss a patient’s medical condition with designated family members/loved ones)

Generally speaking, visiting hours are from 8am to 7pm. However, these hours may be extended or reduced depending on several factors including the needs of the patient and the needs of other patients in the unit.

Visitors under the age of 12 are strongly discouraged for their own safety. Not only can the Critical Care Unit be a traumatizing experience for children, they are also at greater risk of picking up infections. Please talk to staff if you feel an exception is necessary.

Family Spokesperson

A family spokesperson is usually (but not always) an immediate family member of the patient who is elected by the family to relay the information between the Critical Care Team and the entire family. This person should be someone who listens well, speaks well, tends to remain calm in a crisis, and is respected by other family members.

A spokesperson benefits the family by relaying updates and status reports on the patient’s condition to family and friends. A spokesperson benefits the patient and ICU Care Team by eliminating the time spent with telephone calls from multiple family members, and leaving more time to spend with the patient.

Once a spokesperson is selected by the family, the spokesperson’s name and telephone number(s) should be given to the Critical Care Unit nurse.

Why is the Door Locked?

Many people are upset that we lock the door to the Critical Care Unit. However, we are not trying to make it more difficult for you to see your loved one – in fact, we do it for the sake of our patients. We promote a healing environment at the Health Sciences Centre, and that is especially important in the Critical Care Unit. Having a locked unit means fewer interruptions for nurses caring for your loved one, and reduces the traffic in and out of the unit for a quieter, more restful environment.

Family Waiting Room Etiquette

The Family Waiting Room is a very special place for family and loved ones to gather. It is designed to be a quiet area to wait temporarily while visiting a loved one in the Critical Care Unit. For these reasons, we ask that you:

  • Have only two family members in the waiting room – others may wait in the cafeteria, lobby, or other areas of the Health Sciences Centre
  • Please be respectful of other families in the waiting room
  • Use hand sanitizer when entering and leaving the unit
  • Please keep the area tidy and free from garbage
  • Avoid sleeping overnight – you will be much better rested and will benefit from getting away

What to Expect

Visiting a loved one in the Critical Care Unit can be upsetting for many people for several reasons. Patients are often connected to various pieces of equipment. Patients may be unconscious or unable to respond to you. In some cases, patients may be coming to the end of their lives.

Our staff is obviously there to help patients, but we also help family members during what is usually a very difficult time. We encourage everyone to ask questions. We may not be able to answer all questions, such as direct questions about a patient’s health due to confidentiality issues, but we will do what we can to help.

It is important to note that visitors play an important role in the healing process. Even when patients are unconscious or too weak to speak, they may be aware of a familiar voice talking to them (even if they don’t react). Try to talk normally and even touch your loved one by taking their hand or touching their arm.

Don’t be alarmed if you notice that your loved one’s hands are loosely tied to the bed rail. We do this simply to ensure that the vital equipment attached to your loved one does not get disconnected during sleep or movement.

The Equipment

Each room in the Critical Care Unit contains specialized equipment to help monitor patients or help them perform vital functions. It may be overwhelming to see so many tubes and equipment attached to your loved one, but they are there to help provide the best care possible.

The Ventilator

Although noisy, the ventilator is essential for those patients who have difficulties breathing including maintaining a correct breathing pattern. Some patients may find the ventilator uncomfortable, but it is often a life-saving piece of equipment. This machine may be monitored and adjusted regularly by your critical care nurse. An alarm may sound if your loved one’s breathing pattern changes.

Feel free to talk with the patient, even if they are on a ventilator. However, avoid asking questions (and discourage the patient from talking). Just the sound of your voice will be comforting, and will help them feel connected to you.

Tubes and Wires

Chances are you’ll notice many tubes and wires running from your loved one to various pieces of equipment in the room. Various electrodes and wires help monitor vital signs like heartbeat, breathing, blood pressure, and others. Intravenous (IV) tubes carry medicine, nutrients, and fluids. If the patient is unable to eat, a feeding tube helps carry liquid food directly to the stomach. Finally, a catheter may be inserted into the bladder for patients who are unable to use a bedpan.

Monitors

Various monitors, often beeping or making other noises, record vital signs including heart beat, breathing, and other vital signs. These monitors may also trigger an alarm if one or more vital signs are outside of normal range. They are highly sensitive due to the critical nature of the patient’s condition, and may trigger an alarm for something as harmless as moving. Once an alarm has been triggered, your critical care nurse and/or other members of the team will come immediately to assess your loved one. If this happens, please give us room to properly care for your loved one.

Please feel free to ask your critical care nurse about any equipment and its purpose.

Transfer to Another Inpatient Unit

When a patient’s condition improves to the point that he or she doesn’t require critical care services any longer, the patient will either be discharged or moved to another inpatient unit. In some cases, the patient may have to wait for a bed to become available. During that time, the patient may be disconnected from much of the equipment. Also, other aspects of the patient’s care may change including how often vital signs are checked, the number of people caring for the patient, etc.

This is not cause for alarm – in fact, it is a good thing because it means the patient’s condition has improved to the point that he or she no longer needs to be monitored as closely.

End-of-Life Considerations

The unfortunate fact is that for many, a visit to the Critical Care Unit is the first time patients and families discuss end-of-life care. The Critical Care Unit has developed a brochure to help patients and families through what can be a difficult process to ensure that the right decisions are being made at the right times to respect the patient’s wishes.

Critical Care Team

Intensivists
An intensivist, also known as the most responsible physician (MRP), is the physician in charge of the patient’s care while in the Critical Care Unit. He or she communicates with other members of the team on a daily basis. The intensivist may also consult with other physicians who are specialists in particular areas of medicine or surgery (such as heart, kidney, or lung specialists).
Nurses
Critical care nurses are the minute-to-minute critical care providers. They not only help to provide, but also coordinate most aspects of care delivery. They have received specialized training in caring for critically ill patients. Because care is delivered around the clock, you may encounter many nurses during a patient’s stay. Critical care nurses communicate with each other, the intensivists, and other members of the team regularly and in a coordinated fashion to ensure the best care.
Registered Respiratory Therapists
Registered respiratory therapists have special training and experience in caring for patients with breathing problems. They work closely with others in the critical care team to develop a plan to support a patient’s breathing. They set up, monitor, and maintain the breathing machines (mechanical ventilators), and they adjust these machines minute by minute and hour by hour to best meet the patient’s needs. They also give breathing treatments, suction secretions from the breathing tubes, and set up and maintain oxygen delivery devices as well as many other pieces of breathing equipment.
Pharmacists
Pharmacists collaborate with the intensivists to select the right medicines at the correct dose for patients, and monitor drug levels in the body. Pharmacists also help to decrease medication side effects and provide valuable information to the team members.
Physiotherapists
Physiotherapists are involved in the care of critically ill patients early on in their stay. The earlier patients start a rehabilitation program, the better their chances of regaining their maximum function.
Dietitians
Dietitians calculate the nutritional needs of the critically ill patient and collaborate with the intensivist to provide the patient with the best possible diet, whether orally or through a feeding tube. As nutrition is extremely important to the recovery of the critically ill patient, they closely monitor the nutritional balance on an ongoing basis and make changes according to the patient’s needs.
Medical Radiation Technologist
Technologists specially trained in taking X-ray pictures are often found in the Critical Care Unit with their X-ray equipment. They only take X-rays ordered by the intensivist.
Medical Laboratory Technologist

Technologists specially trained in obtaining blood samples for laboratory tests come to the Critical Care Unit when tests are ordered by the intensivist.

Trauma Coordinator
The trauma coordinator reviews the plan of care for each trauma patient and makes suggestions regarding patient needs in consultation with the Critical Care Team. The coordinator also works closely with the patient and family, providing education and information to the patient and family about the patient’s progress and expected outcomes. While visiting the patient each day, the coordinator works to help smooth the transition of the patient between various departments of the Health Sciences Centre as the patient moves through the rehabilitation process.
Social Worker
Social workers provide professional assistance with the needs of patients and families. They can help to assess and determine what resources patients and families might be lacking, provide them with information on agencies to assist with various needs, and generally assist with other family difficulties.
Clinical Nurse Specialist
Clinical nurse specialists are nurses who provide ongoing education for critical care nurses on new practices, protocols, and new equipment. They are up-to-date with the best practices in critical care and communicate with the manager and with critical care nurses about all aspects of nursing practice and education. As an important part of their role, they provide a comprehensive orientation to nurses new to the critical care team as well as providing continuing advice, support, and education for all nurses in Critical Care.
Ward Clerk
Ward clerks help with communication by answering the phones, processing the intensivists’ orders, and coordinating some of the patient activities in the Critical Care. They are good resources regarding the Critical Care Unit and the Health Sciences Centre in general.
Pastoral Care
Chaplains who serve in a non-denominational capacity are available to minister to the spiritual needs of patients and families. If you wish to speak with a chaplain, please ask a nurse to call one for you. Don’t hesitate to contact your own spiritual advisor for support as well.
Manager
Managers are nurses with additional experience and education who are responsible for the day-to-day operations of the Critical Care Unit, ensuring the highest levels of care and safety. The manager is also available to assist patients and families with their needs.

Questions

If you have any questions about the Critical Care Unit, please talk to the critical care nurse providing care to your loved one, or contact Wendy Winslow by email (winsloww@tbh.net) or by phone through the switchboard (807-684-6000).