What happens after leaving ICU?
When you have been ill and in intensive care, it may take time for you to return to your normal self. Exactly how long it will take will depend on
- how long you've been ill
- any weight you've lost since coming into hospital
- any further complications following your time in ICU
- your health before your illness.
After your stay in intensive care, you might notice changes in your activity levels, your mood, eating and drinking, and your sleep pattern. If you do experience any problems, it may be reassuring to know you're not alone.
Going to the ward
Going to the ward is a big step on the way to recovery. It's quite normal to feel apprehensive as you and your family have become familiar with the staff, equipment and monitoring, and routine in intensive care. The thought of meeting new people can be worrying at any time, but it may seem harder when you 've been very ill and the new people are those looking after you. The staff on the ward understand your feelings, as they are used to looking after people who have been seriously ill. They can reassure you and answer questions, or if necessary they can contact the intensive care staff if you have specific questions about your stay there.
You will notice on the ward there are fewer nurses for each patient compared to intensive care. You won't have one nurse looking after just you, as you may have had on intensive care. This is because you are improving and will soon be able to do more for yourself. Not having a nurse in sight may feel frightening at first, but the nurses will be nearby if you need them. If you need any help, there is a call bell for you to use and the nurses will be with you as quickly as possible.
The first few days on the ward may not be easy for you and your family. You may feel scared, insecure and anxious. These are all normal fears. Try to remember that you are getting better and are well enough to be on the ward. If you're very worried, discuss your feelings with the ward doctors and nurses.
At first, you may get tired easily and find it hard to do some activities. This is to be expected and will improve with time. Unfortunately it is difficult to place a time scale on your recovery, as everyone improves at a different rate.
You will have to gradually increase your activity over the following days or weeks and initially may need help from the nurses or the physiotherapist. You may feel frightened to do certain things - if so, please discuss this with the ward staff and they can reassure you about what to expect from yourself during your recovery.
Changes in mood
Some patients comment on their changing moods, being a little ‘down’, feeling depressed or snapping easily at their relatives or friends. These are normal reactions after being very ill and they will subside with time.
It may also take a while for you, your family and friends to come to terms with what has happened to you. It may have been a very difficult time for everyone involved, but discussing your experiences will help you all understand what has happened and assist in your recovery. You may wish to talk to someone other than family or friends. The nurses and doctors on the ward will be able to help, or once you are home you can contact the ICU follow-up team at firstname.lastname@example.org.
Eating and drinking
Since being unwell, you may have lost weight and your appetite might have changed. Loss of appetite or altered taste is usually temporary and should return to normal with time. Initially on the ward, you may need help with eating and drinking. Nurses, relatives and friends can help you with this until you are able to feed yourself again.
Whilst in hospital, you may be given meals or drinks fortified with extra nourishment, which are important to help you get better. Sometimes these food supplements will need to be continued at home. If this is the case, there are many different types of food supplements available at your local chemist, or you may be able to receive them on prescription from your GP.
A sensible balanced diet is an essential part of your recovery. You'll need to eat and drink the right foods to help you recover, but it is important for you to be happy and enjoy what you eat and drink as well.
If you have any problems with your diet, ask the ward staff or your GP to refer you to a dietitian for more specific advice.
Sleeping, dreams and delusions
You may find your sleep pattern has changed. This is partly due to the disruption of sleep in intensive care and on the wards. Your body is less active, the wards may be noisy and you may have received drugs in intensive care which will have changed your sleep pattern.
Some intensive care patients experience nightmares or strange dreams or delusions whilst in intensive care, which may continue on the ward. These dreams can be very vivid and disturbing, and are likely to be caused by a combination of the drugs you received, infection and a disrupted natural sleep pattern. Discuss your experiences with the ward doctors and nurses. These dreams or nightmares do subside over a few days or weeks and often natural sleep will help .
Lack of sleep may make you feel very tired and lethargic. It is important to remember that lack of sleep over a short period of time is not harmful. As you recover, your sleep pattern will return to normal.
ICU follow up team
Once you've gone home, the follow up team will call you to see how your recovery is going. If you have any concerns or questions regarding your recovery or relating to your time in GICU, please share them with this team. If it is felt necessary, the team will advise you to attend an ICU follow up outpatient clinic with members of the multi-professional team.
More information about intensive care is available from ICU Steps, an intensive care patient support charity. Visit their website here.