Nursing care in ICU

In the intensive care unit people are constantly looked after and monitored by a highly specialised team, which includes consultants, physiotherapists, dieticians and nurses, each of them with specialist knowledge and skills. Specially trained nurses provide round-the-clock care and monitoring, and there is a high ratio of nurses to patients – each person in ICU is usually assigned his or her own ‘named’ nurse.

ICU nurses play a vital role in the patient’s care, including the following:

  • Taking regular blood tests
  • Changing the patient’s treatment in line with test results
  • Giving the patient the drugs and fluids that the doctors have prescribed
  • Recording the patient’s blood pressure, heart rate and oxygen levels
  • Clearing fluid and mucus from the patient’s chest using a suction tube
  • Turning the patient in his or her bed every few hours to prevent sores on the skin
  • Cleaning the patient’s teeth and moistening the mouth with a wet sponge
  • Washing the patient in bed
  • Changing the sheets
  • Changing a patient’s surgical stockings, which help circulation when he or she is inactive (lying still) for a long time
  • Putting drops in the patient’s eyes to make it easier to blink

Here people talk about the nursing care they received in ICU.

Most people spoke highly of all the staff in ICU and the care that they received, particularly from their named nurses, even if they couldn’t always remember their names. For many the care was ‘excellent’ and the nurses were kind, encouraging, professional and calm. Several people discussed memorable experiences they’d had while in intensive care, such as celebrating birthdays, and one man recalled how the nurses arranged for him to leave ICU briefly and see his dogs, in the hope that this would help him recover.

She recalled how the nurses went out of their way to help her feel cared for and positive.

Age at interview 47

Gender Female

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He had no clear memories of being ill in intensive care but enjoyed his stay.

Age at interview 71

Gender Male

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Many people felt comfortable and secure in ICU because of the nursing care they received. Several people noted how they were treated ‘like human beings’, that the nurses became ‘like friends’, and were good at accommodating the many and differing needs of the individuals under their care. Some recalled that, despite the serious environment of ICU, they shared many moments of laughter and jokes with doctors and nurses.

He recalled how nurses joked with him yet were quiet and gentle with people who needed a…

Age at interview 60

Gender Male

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He said that he was cared for by fantastic and caring nurses of every nationality.

Age at interview 63

Gender Male

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Some women praised the pampering and care they received from nurses – including nail-care and shaving legs and under-arms – which helped them feel better about themselves and how they looked.

She felt more positive after having her legs shaved by nurses and her eyebrows shaped by a beauty…

Age at interview 44

Gender Female

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Relatives of those who had been in intensive care also praised the nursing care in ICU, and talked positively about the reassurance and information staff had given. This carer became attached to the first named nurse who looked after his partner and he was worried when another nurse was going to replace her.

His fears were unfounded and he was reassured to find that all the nurses in ICU were excellent.

Age at interview 46

Gender Male

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Although the UK National Health Service (NHS) is often criticised, some people said that their own experiences of nursing care in intensive care were, in contrast, ‘brilliant’.

He praised the hard work and care of the ICU nurses as well as the food and cleanliness.

Age at interview 54

Gender Male

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He appreciated the staff working in ICU and the difficulties of imparting bad news to patients…

Age at interview 46

Gender Male

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Many people were grateful to all the staff who had cared for them and had helped them to survive and recover. One woman, whose husband was admitted to ICU after an accident, recalled how one of the nurses talked sternly to him while he was sedated but succeeded in stopping him pulling out vital equipment. Others noted that the care they received was as good as any they’d had in the private sector.

The care he received couldn’t have been better and he praised staff working at every level of the…

Age at interview 71

Gender Male

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Some people said it was important for them to get on well with the named nurses because they were completely dependent on them for their care. A few said they felt ‘like children’ because they needed nurses to do everything for them. They compared the care they received to that of a mother looking after a child. Others noted that they were happy both with the overall care they received and the honesty with which information or news was imparted. One carer said the doctors were more cautious when imparting news compared with the nurses, who were usually ‘upbeat’ and optimistic (see ‘Information‘).

Several people said that, although the majority of nurses in ICU were good, a few were unhelpful, unkind or unfriendly.

She felt that her care was inconsistent because some nurses helped her with daily activities…

Age at interview 44

Gender Female

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She was happy with her care but advises nurses to remember that patients are intelligent people…

Age at interview 38

Gender Female

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For many, the amount of equipment and constant attention and monitoring in intensive care contrasted dramatically with their experiences of the general ward (see ‘The general ward’ care and environment‘). A few people were disappointed with their care because they felt that the ICU nurses spent more time checking equipment than talking with them and learning about them as individuals.

She felt that nurses were desensitised and uncaring when they put monitoring technical equipment…

Age at interview 55

Gender Female

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A few people noted that the overall care they received was extremely good but they often didn’t see the same nurse or doctor twice. Sometimes, this made it difficult to build a trusting relationship.

What is a care bundle?

Care bundles were developed to help achieve standardised health care and best practice. Care bundles are a collection of interventions (usually three to five) that have been recommended as best practices, based on evidence, in the treatment and management of a particular condition. By putting these interventions into a bundle, it is hoped that this will produce a standard approach to delivering core elements of care which will reduce risks for patients. What is in each bundle will vary and it is not intended to be a comprehensive list of all care that should be provided, but should form the basic level of care that should be expected and must be adhered to for every patient, every time. All the tasks are necessary and must all occur in a specified period and place.

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