Critical Care

Photographs

Please note, photographs MUST only be taken by critical care staff and NOT family and friends. This is because the patient’s consent must be sought in order for any photographs to be taken.

Photographs can be a powerful means of helping a patient to understand what has happened to them during their stay in ICU and may enable them to put their experiences and ongoing recovery into perspective.

An initial photograph will be taken by staff within the first 48 hours of admission. Subsequent photos will be taken to show stages of recovery and the layout of the bed space and the critical care unit. Consent for staff to take photographs will be obtained whenever possible.

However, photographs may be taken without a patient’s consent when it is considered to be in their best interest. The potential benefits to the patient permits the taking of a photo of a critically-ill patient at a time when they are not able to express their agreement. Relatives or members of staff may be photographed with the patient if they wish and they give their consent.

Photographs are kept in a digital format and uploaded to a secure system which is only accessible by designated staff. Photographs will not be given to family and friends and they will only be printed if the patient gives consent to keep the photos.

Sick certificates/letters

If a sick certificate is required for a patient’s time in critical care, please speak to a nurse or a member of the team who can arrange this for you. We can support patients and families with a headed letter to employers, GPs, or insurance companies for the period of the critical care admission.

Patient property

Whilst we can accommodate a small amount of patient property on the unit, we would encourage families to take their loved one’s property home with them for safekeeping. Should valuables remain on the unit they will be documented in our valuables property book and sent to the hospital’s safe to ensure they are kept in a secure location. These can be retrieved by the unit staff when requested by the patient.

Following the death of a patient their next of kin will be able to retrieve their loved ones belongings.

Wi-Fi

Free Wi-Fi is accessible to the public throughout the hospital.

Infection control

To protect our vulnerable patients, all visitors to our critical care units are asked to wash their hands prior to visiting and after they have visited their loved one. On occasions certain Personal Protective Equipment (PPE) may need to be worn when visiting the unit. If PPE is required the nursing team will speak to you either prior to your visit or on arrival.

Please do not visit the unit if you are feeling unwell or you are displaying symptoms of COVID-19.

If you are concerned about the risk to your own health when visiting the unit, please speak to the nurse in charge.

Same sex accommodation

We appreciate the importance of same sex accommodation for the comfort, privacy and dignity of patients. While we aim to achieve this there may be times within ICU, the High Dependency Unit and the Enhanced Care Unit (ECU), where this is not possible due to the severity of illness of our patients. If you are concerned about mixed sex accommodation please speak to the nurse in charge.

Patient diaries

Patients who have received care on the Intensive Care Unit (ICU) often have little or no memory of their stay. This can be due to the illness itself or the sedative drugs they were given to keep them comfortable. Some patients may also remember or suffer ongoing nightmares or hallucinations from their time on the unit.

Although doctors and nurses explain to patients why they were admitted to ICU, patients sometimes forget what they have been told. Research suggests that patients can become stressed and anxious when they do not fully understand what was wrong with them. To help patients understand more about their illness and their stay on ICU, our staff have introduced patient diaries, which have been shown to help reduce stress in patients after they are discharged to a ward and in the months following their stay.

The nursing staff will make diary entries to explain why the patient was brought to ICU, what is wrong with them and how they are progressing. We encourage family members to add messages in the diary too, including any news from home they might like to know about. To do this simply speak to the nurse looking after your relative about what you would like them to add on your behalf. Please avoid using any language that could cause offence to the patient or others who may read the diary afterwards.

Once the patient is well enough and they have been moved to a general ward, the ICU nursing team will make contact with them and go through the diaries in person with them.

If you have any questions about patient diaries, please do not hesitate to ask the nurse looking after your relative.

Please remember that the diary is hospital property until handed over to the patient. Diaries must not be taken away from the bedside by family members.

Rehabilitation

How you can help…

Rehabilitation starts on day one of admission. As your relative’s condition improves it is important that they start to feel like themselves again. To help with this process, we ask that you bring in:

• Photographs of those important to the patient
• Mobile phone
• Cards from loved ones
• Drawings/letters from children within the family which can put up around the bed space
• Loose fitting clothing/cardigans/pyjamas as these items of clothing are easy to put on and remove
• Loose fitting underwear
• Appropriate footwear/slippers
• Headphones to listen to music – please speak to the nursing team about the patient’s preferred choice of music
• DVDs
• Kindle/books
• iPad/tablet
• Toiletries, detangle brush/comb
• Netflix/Disney/Now/Amazon Prime account information for your loved one to login to – if you have an account and your relative would like to use it please let the bedside nurse know so that this can be set up.

This is Me

You can help your relative by completing the ‘This is Me’ document, which will help us to support your relative in an unfamiliar place. It includes information such as your relatives preferred name, what their hobbies and likes are and what is important to them. You can download a copy to print so you can complete it at home and bring it with you when you visit. Alternatively, please speak to your relative’s nurse who can print you a copy of the form so you can complete it on the unit.

Lastly, you can help to support your relative by looking after yourself. We appreciate that eating and resting is difficult at such a stressful time but it is very important that you maintain your energy and strength.

Follow up information

The critical care follow-up clinic provides an opportunity for the nursing team to discuss with patients what they should expect from their recovery and for the nursing team to see what progress has been made after the patient has been discharged from ICU.

Patients who have been in critical care for more than three days, or were ventilated during their ICU stay, will receive a letter inviting them to attend a follow up appointment approximately two to three months after they have been discharged from hospital. However, any patient who has been in critical care is also welcome to self-refer and book an appointment via the email at the bottom of the letter.

The aims of the intensive care unit (ICU) follow-up clinics are based on the principles of the NICE guideline 83 (2017) for rehabilitation after critical illness, these include:

• Providing information for patients or relatives on their ICU stay. Patients can discuss any concerns about memory problems and their recovery
• Identifying, supporting and providing guidance to patients and relatives regarding physical and psychological issues
• Facilitating onward referrals for specialist care (medical and psychological)
• Providing a contact person for on-going support
• Functional assessments
• Individualised staged rehabilitation programmes.

An important aspect is to also gather feedback on the experience and delivery of the care we provided to both patients and their families while they were on the unit so we can understand what we did well and where improvements can be made.

The critical care follow up clinic is run weekly on a Monday afternoon.

For more information please contact Clinical Nurse Specialist, Critical Care Rehabilitation and Follow Up Nurse, Hanna Ramanouskaya – h.ramanouskaya@nhs.net

Other useful resources The ICUsteps website  is a highly recommended free support service for former ICU patients. It was founded in 2005 by former ICU patients, their relatives and ICU staff and includes an online community group. Other resources that may be helpful include:

• Asthma UK Asthma
• British Heart Foundation
• BRAKE | The Road Safety Charity
• British Association for Counselling and Psychotherapy British Association for Counselling and Psychotherapy
• The Colostomy Association Colostomy UK – A UK charity supporting people with a stoma
• Cruse Bereavement Care Home – Bereavement Support
• Medway Talking Therapies
• Diabetes UK Diabetes UK

Facilities

Shower room – Please feel free to use the relatives’ shower room. A member of staff will assist you in unlocking the room and can provide you with towels if required.

Waiting area – Please help yourself to the complimentary teas and coffees that are available. If supplies need replenishing please speak to a member of staff. A TV and a selection of books and children activities are also available in the waiting area.

Car parking – Seven-day concessionary parking is available for relatives and carers of critical care patients. Please ask the nursing team for a form. Please note the complimentary parking is one per family.

Visitors’ rooms – We have two rooms available for relatives to use overnight. Please note, if the rooms are used overnight they need to be vacated by 8.30am the following day so they can be cleaned. The key must also be handed into the ICU nurses’ station and not taken off the unit. The rooms are kept free during the day so doctors and nursing staff can meet to discuss confidential information regarding patients with their relatives.

Mobile phones – We politely request these are placed on silent and calls are taken or made away from the patient’s bedside.

Food and drink – Please be aware that while food and drink are not permitted at the patient’s bedside these can be consumed in the waiting area on the unit. If you require refreshments you can visit the League of Friends shop, which is located in the main entrance of the hospital on Level 2. The shop sells hot drinks and food, as well as cold drinks, snacks, sandwiches, newspapers, magazines, and essential toiletries. It is open Monday to Friday from 8am to 8pm, weekends 8am to 6pm and bank holidays from 8am to 4pm. Below Deck Galley (located on Level 1 in the Purple Zone) is also open to visitors and people attending outpatient appointments from 3pm to 7pm Monday to Friday and 8am to 7pm on the weekend.

Friends and Family Test

Patient feedback is really important to us. Listening to the views of patients, and their friends and family, allows us to understand what is working well, and what we need to do to improve our services to ensure we deliver the very best of care to patients at all times. It also allows us to improve the hospital environment for everyone.

Our Friends and Family Test (FFT) provides all patients, as well as their carers and loved ones, the opportunity to leave feedback on their care and treatment. The questions are short and simple and the survey takes no more than a few minutes to complete.

You can access the FFT in a variety of ways. You can either click on one of the links below, or use the camera on your handheld mobile device to scan the QR code displayed on posters and / or pull-up banners on the unit. Some of our staff may also show you a QR code on a sticker on the back of their staff ID badge. When you scan the QR code simply click on the link that appears to be taken to the FFT to complete. You will need to click on the drop down menu to select the area you or your relative attended or were cared in.

However you choose to access the FFT, which is completely anonymous, we encourage you to be as honest as you can about your, or your friend or family member’s, experience of our services, staff, and procedures. There is also a section for you to make suggestions for improvements. We really do welcome your honest feedback as it allows us to make the changes that matter to you, and in turn helps to improve the experience for others.

If you have any queries about the FFT, or if you have any issues accessing the link below then please email medwayft.qualityandgovernance@nhs.net

• Adult Friends and Family Test
• Please contact us if you would like to raise a concern or make a complaint

Accommodation

Below is a list of nearby hotels should you require accommodation when visiting loved ones in critical care.

Travelodge Chatham Maritime
Distance: 2.41km
Chatham Historic Dockyard,
Western Avenue
Chatham,
ME4 4NT

The Ship & Trades
Distance: 2.75km
Maritime Way, Chatham Maritime
Chatham,
ME4 3ER

01634 895200

Premier Inn Gillingham / Chatham Victory Pier
Distance: 2.09km
Blake Avenue
Gillingham,
ME7 1GB

Te: 03333 219353

Premier Inn Gillingham Business Park
Distance: 3.37km
Will Adams Way,
Gillingham,
ME8 6BY

Find a pharmacy

You can find a nearby pharmacy by visiting the NHS website.