when a loved one needs critical care

Patricia Carroll, RN,C, CEN, RRT, MS

If a loved one is a patient in critical care, it’s a stressful time for everyone. One group that works to make this a less stressful time for families and educate the nurses caring for your loved one is the American Association of Critical-Care Nurses (AACN).  I have been an active AACN member for a long time and have worked with them on this page for you.

Here are tips from experienced critical care nurses:

1. Designate one family member as a contact person who regularly talks with the nurse. Other family members should call that person instead of calling the nurse directly. That way, the nurse can spend as much time as possible with the patient and less time on the phone repeating the same information to different family members.

2. The American Association of Critical-Care Nurses supports including family members as partners in the care of critically ill patients. Nursing research has shown that more liberal visitation is best for the patient and more satisfying for the patient and family. AACN recommends a less restrictive approach to family visiting, with individualized visiting guidelines based on the patient’s needs and preferences and the family’s wishes. If you feel your visiting time is too restricted, talk with your loved one’s nurse to work out an arrangement that works best for everyone.

Click here if you’d like to read what’s being published for nurses about this topic. 

Don’t be afraid to talk to or touch your loved one even if they are unconscious. If there are tubes and wires, ask the nurse how you can hold your loved one’s hand or stroke their face. Touch can be very healing.

Do keep in mind that if there is an emergency with another patient, you may be asked to leave so that the healthcare team can focus on the emergency. We don’t want you to unintentionally get in the way of another patient’s emergency care.

3. You have the right to know the identity of every person taking care of your loved one. If someone without a visible ID badge comes to the bedside, ask for their name and what they do. Many people dress alike -- especially in scrubs -- you should know who’s who.

4. If you have a problem with a member of the healthcare team, and the nurse caring for your loved one can’t solve your problem (or is the problem), ask for the charge nurse, nurse manager or nurse supervisor. During regular business hours, you can also ask for the hospital’s patient advocate or patient representative. That person’s sole job is to solve problems for patients and their families. Don’t be shy and don’t suffer in silence. It’s hard enough going through a loved one’s illness. Speak up if you have concerns.

5. Don’t hesitate to keep a notebook in which you and other visitors can write questions as they come to mind and take notes so you remember things to share with other family members.

6. Do not send flowers or plants to someone in critical care. There is not much space around the bedside, and flowers and plants can bring germs into the intensive care unit.

7. Read the Patient and Family Rights and Responsibilities document. The hospital must provide this to the patient or his or her representative on admission. Remember something we all learned when we first started working in hospitals, "What you hear here, what you see here, must remain here, when you leave here." That's to remind you that other patients have a right to confidentiality. As a visitor in critical care, you may overhear private, confidential information about other patients -- even the fact that they are patients. That information cannot be shared with anyone. 

8. Ask your family member’s nurse what to expect the first time you go in to see your loved one. That way, you’re less likely to be taken by surprise when you walk to the bedside, particularly if the patient has been injured in an accident, had surgery, or is hooked up to a lot of machines.

9. If you are going to leave the bedside, be sure to put the rails up on the bed or call a nurse to put them up before you leave. We never want to leave the patient alone with the railings down -- it’s an important aspect of patient safety.

10. A nurse can call a spiritual advisor to talk with you or pray with you and your loved ones. Many hospitals have non-denominational chaplains on staff and in the hospital ready to assist. Your own pastor, rabbi or other religious supporter is also welcome.

11. Be sure to take care of yourself – don’t forget to eat, sleep and take some time away from the hospital. If you are rested, you can provide the best healing support for your loved one.

12. If you or another family member has a potentially contagious illness, please do not come to the hospital. We don’t want your loved one to catch a disease from you when they’re already recovering from an illness or accident.

13. We understand this is an overwhelming and stressful time for family members and loved ones. You may feel confused, helpless, afraid and angry. These are all normal reactions. Don’t hesitate to talk with your loved one’s nurse or another member of the healthcare team if you feel the need to talk out these feelings. Counselors are available -- just ask.

One of the reasons I am so proud to be a member of AACN is their vision statement:

AACN is dedicated to creating a healthcare system driven by the needs of patients and families where critical care nurses make their optimal contribution.

You, our patients, and their loved ones deserve nothing less.

Written: July 2001

Reviewed: May 2003, May 2004