Intensive Care Unit at West Suffolk Hospital provides follow-up care for patients

12 August, 2002

The Intensive Care Unit at the West Suffolk Hospital has introduced a follow-up programme to care for patients after they are well enough to leave the unit.

This is in response to research which shows that patients can suffer profound problems after critical care, especially if their stay is for 4 days or longer. These problems may remain unrecognised by patients, their relatives and health care professionals, and so get worse until they become chronic.

Physical difficulties can include fatigue, itching, eating or sleeping problems, or drug dependence. Psychologically, patients can experience depression, panic attacks, post-traumatic stress disorder, disturbing memories, nightmares, flashbacks and hallucinations. They can also encounter social problems such as altered family dynamics, differing expectations of relatives and sexual dysfunction.

The follow-up programme aims to help patients by reassuring them that a slow recovery with ongoing problems is normal following a serious illness or injury. Follow-up Sister Denise Stubbs provides support by visiting patients on the wards after discharge from the Intensive Care Unit and providing honest answers to specific questions they might have. She may refer people on to other specialties ranging from dermatology to psychiatry.

"A lot of my role is about re-assurance," said Denise. "By giving people a chance for discussion, and helping them to adjust their lifestyle and produce realistic goals, we can prevent long-term problems."

Another initiative is the introduction of patient diaries. While a patient is unconscious in the unit, their relatives, friends and nurses may write entries in their personal diary. This may be anything from the football results to family events, and is designed to give the patient something concrete to replace the time lost when they were unconscious.

Patients are also offered a tour of the unit when they come to the follow-up clinic.

"For many patients, visiting the ICU is important because they have no memories of their stay there," said Dr Pam Chrispin, lead clinician in critical care. "Meeting the staff and seeing the equipment can be a cathartic process, and some patients really appreciate the opportunity to say thank-you."

Feedback from patients about the follow-up clinic has been positive. Over three-quarters welcomed the opportunity to discuss specific problems. Around a quarter were referred for counselling, with a slightly lower number referred on to other specialists.