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Intensive care: Patients' experiences

Impact on work

Critical illness can have a huge impact on a person's life, and physical and emotional recovery can take a long time. Many people return home from hospital extremely weak and it can take several months before they feel strong enough to do normal daily activities. During this time, if they'd been employed before they went into hospital, they will be unable to work until they are better. 

Most people who've had a critical illness and spent some time in ICU find it takes them longer than they expect to recover and gain enough strength and confidence to return to work. Some of them will need rehabilitation before they can return to work. Others who have been in intensive care after surgery and other kinds of elective treatment may be well enough to return to work after 4-6 months. Here people talk about the impact of their illness or injuries on work.

The people we talked to explained how important work was to them for many reasons - not only financial. One man said he needed to work to get 'some normality' back into his life after a year of 'hospitals and doctors'. A woman said that, even though work made her feel anxious, it also spurred her on and gave her something to aim for.

Planned admissions to ICU
People who are admitted to the intensive care unit after planned surgery can usually prepare themselves and arrange to take time off work, though recovery time can vary from a few months to a year and depends on such things as age, previous health and how ill they'd been. Some people said that they got back to work gradually, at the start working a few hours per day and building up to the number of hours they'd done before their illness. A few had returned to full-time work after six months but needed to take a few hours off each week for physiotherapy. For most, going back to work was a sign that they were 'back to normal' and many said that colleagues had been supportive and understanding.

 

He did a lot of walking while he was recovering at home and went back to work three months after...

He did a lot of walking while he was recovering at home and went back to work three months after...

Age at interview: 43
Sex: Male
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So you were at home, how long did you spend at home before you felt right I'm fit enough to go back to work and...?

Well there is a period where they say that you should not go to work for three months after the op, which I adhered to. But I felt, well what I did basically was I could have, the last month if I was paid fully forever, I could have lived like that. I'd go to the mountains, with the dog, during the morning, get home, pick the children up from school and get the tea ready for my wife when she came home from work. But unfortunately we got to pay the bills, so I had to come back to work but... No, I was good. I was still getting on, going to talk with my GP, the cardiac nurse came to see me twice and said well I don't need to see you again actually, you're doing remarkably well.

Emergency admissions to ICU
People who were admitted to ICU because of an emergency usually spent longer in hospital than those who'd been admitted after planned surgery, were usually weaker and needed considerably more time to recover. For many people going back to work was an important step - some dreaded the prospect but others knew they needed to return. Several people described how surprised they were to find themselves still too tired physically and drained emotionally to cope with their old working environment. The pace of work made many people anxious about going back.

 

She wants to go back to work but is worried she won't be able to cope with the pace, the stress...

She wants to go back to work but is worried she won't be able to cope with the pace, the stress...

Age at interview: 40
Sex: Female
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I think they will want me to, I think they'll be wanting, trying to getting me to do something but, I know they're gonna be quite concerned about coming out [to see me at home] because the last time anyone seen me from work I was in Intensive Care. So although I've like communicated with them on the phone and I've written to different people, they're gonna be like not know what to really expect. Maybe when they see me they're gonna be thinking, there's nothing wrong with her, she can go back now. I think maybe a coupla days might -  

Yeah, is there anything you could do at home or it's not that kind of work?  

No. It's mainly visiting people and being out and stuff so. It's a lot of, it's a lot of getting round, I work as a Housing Officer for a Housing Trust. And so it's a lot of like going to people's houses, or go in flats and up and down the stairs and stuff. So you're out, in out of your car, like twenty visits a day. I just don't think I could do that right now.  

Sounds like quite a lot?

It's quite physical and it's about being on the ball as well 'cause you're dealing with people who, you're not seeing anyone for anything happy or good or for them to say this is great. They all want to moan about something. So they all want you to sort something out, so it's quite stressful in that way, but I wanna be back, I just don't wanna rush back.

Some people who were about to return to work had mixed feelings. They wanted to be strong enough to return to work and their routine but were fearful and anxious that they might not be able to cope. A woman with a young daughter said she discussed her concerns about returning to work with her GP. Another described how she now found her old job too physically demanding for her.

Some people were discharged from hospital but needed to have surgery at a later date. They had given up work and planned to return when they were well enough to work without needing long periods of sick leave.

 

Her GP advised her to return to work only if she could look after herself and her daughter, and...

Her GP advised her to return to work only if she could look after herself and her daughter, and...

Age at interview: 35
Sex: Female
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And all the time I'd been working part-time before I got ill and I was signed off sick for well, until Christmas because it took me that long to kind of get strong enough. But my GP was very supportive in saying, "You know you're not well enough to go back to work until you're well enough to kind of manage at home. You know you're not getting well enough to go back to work and not be able to look after your daughter." So he was really supportive in kind of prioritising that first. And then by the time Christmas came I actually decided, you know, I probably would have been strong enough to go back to work and work was very supportive about saying you know you can come back a day a week and we'll build it up from there but there was a redundancy offer on the table. And I actually decided that I needed just to kind of spend some time with my daughter and spend a good chunk of time being well with her rather than being ill with her. So I didn't go back. 

Many said they found phasing their return to work had worked well. They'd started with working a few hours a day and built up to full-time. One woman said that being critically ill made her realise that she was getting older and she had to try harder to keep up with her younger colleagues. One man said that he did light manual work when he first went back to work until he was strong enough to do more physically. He said he returned to work before the doctor advised him to because he felt bored at home.

 

She lost a lot of confidence when she first went back to work because of the pace and precision...

She lost a lot of confidence when she first went back to work because of the pace and precision...

Age at interview: 55
Sex: Female
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The forms of ageism that you come up again is endemic at work as well. So you kind of, you think, you're always, in my job there are very few people of my age group, there are very few. If I count them, out of 200 odd, I can count them on one hand. Because you need to be pretty quick-witted, work quickly, everything, it's a high level of stress. Everything has to be accurate, precise, obviously because it's banking, can't afford to make mistakes. And there's a lot of pressure in answering the calls and so on and so forth. So it's a high-stress environment. Working at night doesn't help because you have the sleep deprivation. And I really seriously wondered whether I'd be able to function again. 

And it was also, because I work with younger people, you're always having to make certain that you are as good, as fast, as quick and as responsive, as quickly as they are. And I didn't feel that I was. And I really wondered whether I'd be able ever, seriously ever to get back to that again. And I really lost huge confidence.

Many people described how colleagues supported them while they'd been ill. One man said his partner received phone calls from colleagues every day while he was in ICU, offering best wishes and support. Others said they'd received cards and letters. People particularly valued colleagues and bosses who understood how ill they'd been and appreciated that there would be times when they tried their best at work despite not feeling 'a hundred percent'.

Some bosses were fantastic and very understanding. Other people found that bosses had been supportive at first but became a bit less patient as time went on. Several noted that work colleagues in general were completely unprepared for how long it would take them to recover.

 

He was disappointed that his pay would be reduced if he continued working part-time, but later...

He was disappointed that his pay would be reduced if he continued working part-time, but later...

Age at interview: 58
Sex: Male
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I went to see my GP. Fortunately my company had been in touch with my GP and my GP had spoken to the company secretary and they were in agreement that going back part-time for this amount of time would be acceptable though I think they had a time limit set on me. That was probably by the board of directors. Anyway, I saw the doctor and said that I'd reached my maximum, four hours a day. She suggested that I done four hours a day for a couple or three weeks and then try to go up to the five which I did and yes she was right. Within two weeks I got used to the four and I was ready for the five-hour day. So I did, I went to the five-hour day and the company secretary and the MD said they wanted to see me just an update and how I was coping etc. but I think I had, I'd had about three or four meetings with them during my period of re-education.  

And I went in and saw the MD and the company secretary. The MD had said to me that if my six months of sickness was up on the last Saturday and I think this was about a Wednesday I was seeing them, and what he was going to do was look at my annual salary and equate it to an hourly rate and then pay me for the hours I was there. And this I found very obnoxious. I thought they had my interest at heart. I'd done 43 years for this company and here they were talking of cutting my money and making me suffer. There was also the fact that I didn't need this. There were so many things happening in my life, so many things happening different in my life, trying to adjust to work. Trying to remember people's names and things of this nature, I did not want this added worry.  

But I took on board what he said and I think, I know definitely the following Monday was the first time I went back on 8 hours. I done 8 hours and I never looked back. I went on to do a 39-hour week. I am now doing probably a 44/45-hour week. He obviously regretted what he'd said because the company secretary approached me and said, if I could maintain a 30-hour week they wouldn't dock my money. Well to my mind I wasn't far off it. I was doing a five-hour day. That equates to 25 hours a week. I was only five hours lacking and I did do work part of my lunch hour so I was only a couple of hours short of what they demanded. To my mind it was unnecessary. It was added hassle I didn't need but, looking back, it was a challenge. And I always rose to a challenge and they didn't beat me. I beat them. It was probably one of the best things to happen in my life in reflection because it encouraged me to try and get a grip of more of my life as it was.

Some people talked about the longer-term effects their illness had had on their personality and daily life (see 'Attitudes to life during and after recovery'). Several said they were now more assertive at work, others said they were calmer and more 'laid back'. Others were looking for new jobs or a change in career, some wanting 'to give something back', having re-evaluated their lives and priorities. One man said he used to push himself too much at work but felt he now knew when it was time to take a break. One woman was admitted to the ICU in which she was a nurse. Once she was well enough to return to work, she and her colleagues decided to make changes to the way they ran the unit. Many people also said they were extremely grateful to relatives who'd taken time off work while they'd been ill (see 'Impact on family').

 

Her experience of intensive care led her and her colleagues to change several things in their...

Her experience of intensive care led her and her colleagues to change several things in their...

Age at interview: 41
Sex: Female
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So everybody learnt something and we decided that we couldn't not do anything about it, that we would have to make some changes as a unit. And it was simple things that I could tell them, it was things like you don't have any conception of time. It could be day, it could be night, it could be the middle of the afternoon, as a patient you don't know, because the lights are on all night, the lights are on all day. There's activity all night and there's activity all day. So I didn't, half the time I didn't know what time it was, so there were clocks placed everywhere where patients could see them. 

Even down to things like bin lids, when people put their foot on the pedal of the bin and the bin crashes down and you're just dropping off to sleep and, you know, you already think you're in a strange environment, that you've been abducted like by aliens and then this thing comes crashing down. So they changed all the bins so that the bin lids came down very slowly and they didn't crash. We did a booklet for patients who were going to be part of the follow-up clinic, which describes the things that they would go through, about the nightmares, about the pains and the aches, and loss of appetite and loss of concentration, all those kind of things. So myself and the follow-up nurse, we did a booklet for patients, the follow-up team has since been further developed. 

The other thing that we changed was we've decided that, I found it quite hard going from the Intensive Care Unit to the ward, so they decided to step patients level of care down, so that some of the monitoring would be reduced gradually before patients went to the ward so that it wouldn't be such a shock to go from one extreme to another.

Last reviewed August 2018.

Last updated November 2012.

 

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