Intensive Care Unit (ICU)

Intensive Care Unit

The ICU is a special area of the hospital where the focus is on intense observation and treatment with increased staff and resources. This helps healthcare providers to respond immediately during emergency conditions. The trained doctors and nurses with the help of a multi-disciplinary team makes sure that the critical patient recovers rapidly and goes home. Patient who needs close monitoring and treatment are admitted to an Intensive Care Unit (ICU). Some examples of patients needing ICU care include:

Patients with difficulty in breathing needing special machines called, ventilators
Patients with low blood pressure needing monitoring and medicines to treat it
Patients with infections causing septic shock
Patients who need close observation after certain surgeries, such as brain surgery, heart bypass and trauma surgery.

Why ICU ?

Intensive care is needed if someone is seriously ill and requires intensive treatment and close monitoring, or if they’re having surgery and intensive care can help them recover. Most people on an ICU have problems with one or more organs. For example, they may be unable to breathe on their own. There are many different conditions and situations that can mean someone needs intensive care. Some common reasons include:

Types of ICU

General ICU: This ICU provides care across a wide range of conditions, whereas specialized ICU’s [5] provide diagnosis-specific
Some common kinds of Intensive Care Units include:

Neonatal Intensive Care Units (NICU): This ICU provides care for new-born infants
Paediatric Intensive Care Units (PICU) that provide care for children,
Coronary Care and Cardiothoracic Units (CCU/CTU) for heart attack or heart surgery patients
Surgical Intensive Care Units (SICU) for surgical patients
Medical Intensive Care Units (MICU) that provide care for patients with medical conditions that does not require surgery
Transplant ICU where post-transplant patients were kept (like liver, kidney, pancreas, heart, lung transplant units).

Role of Social Worker in ICU

The costs associated with ICUs are high and at times invasive ICU care may not be beneficial, particularly for those patients admitted to ICUs who have little hope for recovery. The process of clarifying medical goals for these patients is often facilitated by addressing psychological factors. Social workers [6] in the ICU are uniquely qualified to assess and address many of the complex psychological circumstances and can clarify potential misperceptions, enhancing communication among patients (if capacitated), their families, and the medical team members. This can help improve the quality of life for very sick and dying patients in the ICU and their families, and may also reduce the likelihood of decision-making conflicts arising. End-of-life issues occur frequently in the ICU.

The specific training and skills received by social workers provide them with the necessary tools to collaborate with interdisciplinary teams and offer holistic care to patients and their families. Research has shown that there is great variation in the level of participation of the social worker, often because they do not have a formal role. Where the ICU team is generally busy and has time constraints, the social worker can take the necessary time to listen, educate and advocate for the patients and their families serving as a bridge between the patients, their families, and the medical team. Social workers provide families with emotional support and information about finances, insurance, and care after leaving the hospital. They are a great resource to answer questions about how a patient will adjust to life after hospitalization.

Effective Communication is the Key

Good effective communication [7] among critically ill patients, their families and providers is often challenging and complex. The dissatisfaction and concerns about poor communication with care providers from patients facing life-threatening illness and their families, are well known. Often, patients cannot speak for themselves; thus family members become the surrogate spokesperson for the critically ill patients. Successful interventions have been identified to improve communication such as the team approach to communication, the formal family meeting and a bundled check list approach. Dealing with aggressive family members when the patient is sick is the most difficult job for the ICU team. To deal with this, understand the family dynamics before consulting with the family by reviewing the patients history (including work, children and marriage), ask family members to introduce themselves and specify their relationship to patients.

Being kind and gentle, but still direct; that is really the only way you can address the fear of attendants. The most effective way of communication with a patient’s family members is to try to listen to what the family members are telling, even though it may not be relevant at that critical time. This is effective because in doing so, you are able to validate the family member’s emotions and they can see how much you care about the patient. They feel that physician is responding to the emotions not the words. This offers a chance for the physicians to display their deep interest in providing relief to the patient and strengthen trust.

With access to