The general ward: care and environment
People are transferred from the intensive care unit to a general ward when medical staff decide that they no longer need such close observation and...
People are transferred from the intensive care unit to a general ward when doctors consider they no longer need such close observation. For many people, moving from an intensive care unit to a general ward in the hospital is an important step on the road to recovery. A big difference between the ward and ICU is that fewer nurses look after many more patients. Some people are transferred directly to a ward, others may go to a High Dependency Unit (HDU) first. Here men and women talk about their physical and emotional experiences while they were on a general ward.
Some people we spoke to couldn’t remember anything about their experiences either in intensive care or on a ward. Others had felt ‘hazy’ and confused when they were first transferred, but most said they were fully alert by this time and able to distinguish between reality and hallucinations.
Many people felt completely unprepared emotionally and physically for the general ward and had mixed feelings about the transfer. They felt relief and happiness to be well enough to go to a ward, but also fear and anxiety about being without the previous high level of support and care (see The general ward: care and environment). Moving from the ICU to the ward can also be a worrying time for relatives.
In the first few days and weeks after a period of severe illness in ICU, the slightest activity is liable to leave people feeling tired. This does improve, though how quickly depends on such things as a person’s age, previous health, how ill they’d been and for how long. Many people talked about physical weakness and lack of mobility when they were first transferred to a ward, including being unable to walk, feed themselves and attend to their own personal care.
Moving to the ward was frightening and worrying, especially for people who couldn’t do much for themselves. Most were completely dependent on nurses for their care at first but, unlike in ICU where they had one-one care, on the ward there were fewer nurses to help them.
Many people also felt that the nurses in general wards were unprepared for how weak and ‘debilitated’ they were, often expecting them to be able to do more for themselves than they could (see ‘The general ward: care and environment‘). Often feelings of tiredness went hand-hand with lack of mobility and severe weakness. Sometimes these were related to an inability to sleep.
Many people talked about the difficulties of being on a ward when they couldn’t walk, lift anything or clean themselves while other patients around them were mobile and relatively well. Some had been extremely weak and immobile when they were first transferred, but gradually made progress. Sometimes progress was slow, but usually on a daily basis, with support from physiotherapists (see ‘Physiotherapy on the ward’).
Some said that, while the move to a ward had initially been unsettling, they soon adapted to the new environment. Several talked positively about being on a ward because it was a sign of progress. They’d become less dependent and more independent, were more alert, mobile and stronger. Learning to walk again, being well enough to have a shower, to feed themselves, lift their arms and legs, were important steps for most, though one man recalled that, although he improved, he was unable to go home because he needed an operation.
Many people felt better emotionally when they saw themselves improving physically. Signs of progress were important ‘milestones’ along the road to regaining strength and going home. Some people recalled feeling emotional and ‘weepy’ when they were first transferred, sometimes because of their weakness or lack of progress. Hospital stays were more difficult for those who had young children and missed them. Upon improving, one woman was allowed home to see her young son during the day and came back to hospital at night.
Some people had felt bored, isolated or unable to concentrate while they were on a ward. A few had nightmares about death and loss of control.
A few people felt a sense of achievement about being on the ward, knowing what they’d overcome and that they were improving. Some also wondered how their illness affected their families, particularly if relatives had far to travel to hospital or children to look after (see ‘Impact on family‘ and ‘Intensive care: experiences of family & friends‘). Once they were improving, many felt eager to rebuild their strength and looked forward to going home.
People are transferred from the intensive care unit to a general ward when medical staff decide that they no longer need such close observation and...
While people are ill in the intensive care unit, they lose weight and can lose about 2% of their muscle mass per day during their...