Patients may be admitted to ICU for a number of reasons. They may be recovering from major surgery, need specialist machines to support them that aren't available elsewhere in the hospital, or just require closer observation than is possible on a ward. Sometimes patients who aren't very sick are admitted because they are at risk of getting worse, and would benefit from being monitored more closely.
When patients are very sick it is often safer to give them sedatives (an anaesthetic) to allow them to rest & recover from their illness or operation. Some of the procedures on the ICU can be unpleasant and sedating patients for these is less distressing for them. Some patients may appear sleepy or be asleep because of the illness that has brought them to the ICU in the first place, particularly if they have suffered an injury to their brain. If you are unsure, please ask the nurse by the bedside whether someone is asleep because of medication being given to them or because of their illness.
To help them breathe while they are sedated, a plastic breathing tube is usually inserted through their mouth into their lungs and attached to a breathing machine (a 'ventilator' or 'life support machine'). Patients are given sedatives until they are better. When the doctors think it is safe, the sedatives will be turned down or turned off to allow them to 'wake up'. There are a number of things that determine how long this carries on for. Some patients need to be sedated for hours, days or even weeks. If they are doing well - waking up, are strong enough, and breathing by themselves - then the breathing tube can usually be taken out.
Everyone is different so please ask the ICU nurse or doctor how long your loved one is likely to be sedated for.
Patients under sedation can probably hear things but we don't know for sure. This will depend on how much sedation they have been given or whether they have an injury to their brain. We know from asking people when they wake up that they sometimes remember things that were said to them when they were sedated.
If they have a breathing tube in their mouth then they will not be able to talk as the tube passes through the voice box (larynx). It is better to assume they can hear you & talk to them normally, even if the conversation is only one-way. We talk to sedated patients as if they can hear us because we don't know for sure if they can't.
Yes. Don't be afraid of upsetting the machines or the monitoring. Holding their hand may be important for you and may also be helpful for them. If you are worried about this, please ask the nurse looking after them.
Please remember to wash your hands before you come into and after you leave the bedside. Infection brought from outside the ICU can be a serious problem for people who are already very sick. If you see any nurses or doctors touching your loved one without cleaning their hands first, please don't be afraid of asking them to do so.
Many sedated patients in the ICU will also have a tube placed through their nose or their mouth. This tube passes through into their stomach. A liquid feed is pumped through this tube to provide the water and nutrients that they need. ICU patients are regularly reviewed by our dietician and doctors to ensure they are receiving the right amount of water and nutrients for their illness.
Patients who are unable to be fed into their stomach or their gut can be given the nutrients through a drip directly into their veins.
If they are likely to be sedated for only a short period of time (such as recovering from an operation) or are unable to swallow or drink, then fluid can be given into their veins through a drip.
If your loved one shows signs of distress or pain then we will give them painkillers for this. These may range from simple painkillers like paracetamol, through to morphine that can be injected into a vein. Even though someone appears asleep, they may still experience pain. Our nursing staff are aware of this and will give painkillers as and when they think patients need it. Some of the tubes may cause discomfort and it is natural for people to try to pull these out. In situations where the tubes are still needed, painkillers can be very helpful.
When patients are awake, they may be given a pump containing morphine or a similar drug with a button to press if they are sore. This is connected to a small pump that gives them a controlled dose of painkiller. This can be very helpful after a big operation or injury. Sometimes we will also insert a thin plastic tube that local anaesthetic is pumped through to numb different nerves around the spine or other parts of the body.
Often not but this varies depending on how heavily patients were sedated and how long they were 'awake' in the ICU afterwards. Patients often don't realise how sick they were until their family and friends who sat by their bedside tell them.
Some patients who stay for longer are offered Patient Diaries for friends, relatives and whānau to complete that may help fill in gaps and piece together their time in ICU.
Patients who are having difficulty breathing due to a pneumonia or other illness (such as an injury to their brain) will often be placed on a breathing machine (also called a 'ventilator' or 'life support'). This machine provides oxygen through a breathing tube and takes over the effort of breathing to allow the lungs to be rested and the problem to be treated with antibiotics or other treatments. Once the original problem that required the machine has improved, the doctors will begin to reduce the amount of work the ventilator is doing and move towards removing the breathing tube as soon as possible.
Patients often require sedation to tolerate the ventilator as the tube can be quite uncomfortable. If the tube is likely to be required for a longer period of time (usually over a week) then the doctors may talk to you about a procedure called a tracheostomy. This is where a shorter breathing tube is inserted directly into the patient's neck. This procedure is nearly always reversible with most patients having these tubes removed either in ICU or on the ward prior to discharge from hospital.
In some patients, it may be more appropriate to support their breathing through a tight-fitting mask that goes over their face. This is sometimes preferable to putting them back to sleep to insert a breathing tube. The doctors will discuss which option is best for your loved one.
Some medications in ICU such as sedation and drugs that increase blood pressure need to be given continuously. These drugs are given directly into a vein (usually through a plastic tube in the neck or under the collar bone) and are pushed through by computer-controlled pumps. The nursing staff will control the speed of the pump based on observations taken from the monitor and other vital signs. Sometime the pumps will make noises to tell us that the lines are blocked or that they are nearly empty. Don't be alarmed by these sounds - the nurses are experts and able to troubleshoot and fix most problems immediately.
The pumps contain batteries and are able to accompany patients around the hospital should they need to be moved for an operation or a scan.
The bedside monitor provides important information that alerts the staff to potential problems. A lot of the wires and tubes you will see attached to your loved one allow continuous monitoring of things such as heart rate, blood pressure and oxygen levels as well as other important signs. These allow us to adjust levels of medication and react to sudden or slower changes in patient's conditions.
The monitor has many alarms that will often make noises or show alerts with flashing lights. These are usually nothing to worry about. Please ask the bedside nurse if you are concerned.
Many patients require strong drugs to be administered that can be dangerous if given through a small vein in the arm or hand. Patients in ICU will often have a 'central line' inserted into their neck or under their collar bone that allows these drugs to be safely & reliably given directly into the bigger veins of the body. These lines also allow us to monitor some of the pressures in or near the heart.
There may be other machine that are sometimes needed to support patients when they are very ill. These include dialysis machines (to clean the blood when the kidneys aren't working) and pumps to help the heart (that may be required after heart surgery or a heart attack). Sometimes these machines can be noisy and will also have their own sets of alarms to notify staff when there may be problems. Please do not be upset by these. Ask the bedside nurse if you are worried.
We have recently changed ICU visiting to increase the time family, friends and whānau can spend with their loved one whilst they are in ICU. This includes during ward rounds in the morning, afternoon and evening.
However, there may still be times when we ask you to step out. For example, sometimes the nurses and doctors are performing procedures such as inserting or removing tubes that may be distressing for you to watch. Patients may also be being washed or toileted when you wish to visit.
Sometimes patients or their families request they only want certain people to visit. If you are not allowed, we will ask you to talk to another family member.
Physical space in the ICU can sometimes be limited and other people may already be visiting. Please be patient with us if you are unable to come in immediately when you arrive. Once the bedside nurse is aware you are waiting, we will try to get you into the ICU to visit as soon as possible.
The hospital Whānau Care service provides cultural and practical support for Māori patients and their whānau whilst they are an inpatient in Wellington Hospital. If you would like their assistance, please let the bedside ICU nurse know and they will contact them for you. You can also contact them yourself by either visiting them in the Cultural Care Centre on Level 2 of the hospital or by ringing 04 806 0948.
More information about the service is available here.
The hospital Pacific Support service is available to help patients and their families in the ICU. If you would like their assistance, please let the bedside ICU nurse know and they will contact them. You can contact them yourself by either visiting them in the Cultural Care Centre on Level 2 of the hospital or by ringing 04 806 2320.
More information about the service they provide to Pacific patients is available here.
Yes. The hospital has the use of a professional telephone translation service which is usually only available during office hours. The ICU staff can book this for you for pre-arranged meetings. If English is not your first language, please let us know what language you would prefer to use. We have a large multicultural staff, meaning sometimes we may be able to provide an interpreter from within the ICU.
We also have access to New Zealand Sign Language interpreters. They may be able to attend meetings in the ICU in person, or if not, will use video conferencing software (such as Zoom) which we will provide. For more information on accessing NZSL interpreters within the hospital, please see here.
Flowers can bring infection in and can be an electrical hazard if water is spilt. Many sedated patients are unable to appreciate them. For these reasons we ask that you don't bring them to patients in ICU.
No. Patient's medical records are private and confidential. People can apply for access to their records by writing to the hospital. An appointment will then be made where they can be reviewed with a member of the medical or nursing staff present to help explain them.
The medical records are available to any visiting doctor or nurse providing care for the patient. For ease of rapid access, they are kept by the bedside whilst the patient remains in the ICU.
At any time. Please ask the bedside nurse if you specifically wish to talk to a member of the medical staff and they will arrange a meeting. Our team will try to meet with you regularly to update you on your loved one's condition. The frequency of these meetings may be determined by how sick they are. We may ask to meet with you if we are concerned about their condition. If you are not in the hospital then we will telephone you.
In the event of an emergency we may not be able to meet with you immediately but will aim to do so as soon as possible. We also recommend that a family spokesperson be nominated to ensure clear communication. This person also acts as a single contact point should an emergency occur.
We are happy to meet with anyone using computer video conferencing software (such as Zoom). Please ask the bedside nurse if you would like us to arrange this.
More information about meetings can be found on the Visiting page.
There are almost 200 nurses who work in our ICU providing round-the-clock cover for up to 24 patients, working 12 hour shifts. As such, it is inevitable different people will be looking after your loved one if they remain in the ICU for more than a few days. We handover detailed information on each patient several times a day and keep written notes so that all information is recorded. These notes are available to any member of staff involved in the care of your loved one.
During office hours, we have a ward administrator who will try to answer telephone calls as quickly as possible. We are also lucky enough to have volunteers who help with visitors at reception. In the evening and at night, the nursing staff will answer the telephone and the door as well as providing patient care so there may be some delay before they are able to talk to you. Although we appreciate that delays can be frustrating, we ask you to be understanding and realise that patient care is always our priority. During any emergency, there may be significant delays.
If there is anyone that you or they would not wish to visit them or obtain information on the telephone, then please provide the nurse with their name and details. The unit is locked & accessible by intercom only so certain people may not be allowed in if requested. To enforce this we ask that the locked door not be held open for other people and that it never be propped open to allow members of your family to visit without them having to ring through first.
We usually ask for a named spokesperson to take responsibility for this so we can refer visitors who are refused entry to them.
Our nursing staff must always be able to provide safe care for our patients and large numbers of visitors can make this difficult. Our bedspace areas are relatively small and when occupied by machines, access to patients can be difficult. Large numbers of visitors can also be overwhelming for people recovering from severe illness. We prioritise the parents of children who may be in our unit and they are able to stay around the clock should they so wish.
When our patients no longer require the level of support and nursing care that we provide then we will discharge them to an in-patient ward in Wellington or transfer them back to the hospital they came from. All discharges are decided by the senior medical & nursing staff and are usually planned in advance, particularly if the patient has been in ICU for some time. There is a written and verbal handover to the ward staff taking over care to make sure all relevant information is passed on. We will always notify the family or whānau spokesperson prior to discharge.
We recognise that discharging long-term patients to a ward can be a stressful time for both patients and their family but without this we would not be able to provide support for other patients who need Intensive Care. Senior nursing staff from the ward will visit patients in ICU to introduce themselves and sometimes patients or family may be shown the ward before they are discharged from ICU.
All patients discharged from ICU will be seen by the Patient At Risk nurse within 2 hours of leaving to ensure the transition has gone smoothly.
For most patients, nothing. Wellington Regional Hospital is publicly funded, meaning that all care we provide to New Zealand citizens or permanent residents is paid for by the Government. This includes any aeromedical ambulance service which is subsidised by charities.
New Zealand has reciprocal health agreements with Australia and the United Kingdom. More information on eligibility for free healthcare in New Zealand can be found here.
If you have a personal injury, even if you are not able to receive free healthcare, your ICU and hospital stay may still be paid for by the Accident Compensation Corporation (ACC). More information on what they may be able to assist with is available here. The ICU staff will initiate an ACC claim on your behalf.
If you are an overseas visitor with travel insurance, we can supply supporting documentation for your insurance company, on request.