People are admitted to an intensive care unit (ICU) because their illness or injuries may be life-threatening and they need intense support while they are treated, constant monitoring and 24-hour nursing care that cannot be performed on general wards. Because critical illness is often a sudden, unexpected emergency, it can change the lives of both the patient and those they are close to in a matter of minutes. The everyday lives of family and close friends may come to an abrupt halt or be turned upside down as they live in the uncertainty of not knowing whether the patient will survive. The ICU, an unfamiliar, alien environment, often becomes the centre of peoples' lives as they wait desperately for any signs of change or progress.
Here people talk about telling others about the patient's critical illness or injury.
When people first found out the patient had been critically ill or injured, they also had to tell other relatives and close friends.
One man explained that, when his wife had suddenly become critically ill, he'd phoned and left a message for their daughter. However, because she'd been on holiday, she hadn't received the message until several days later. A few people said that, because the illness or accident had happened so quickly, it had felt unreal for quite some time and that the first time they told others about it had really brought home to them what it meant.
Relatives and close friends described having had to phone people to make practical arrangements that would enable to them spend as much time as they needed to in ICU. These arrangements included taking time off work, child-care, elderly care and care of pets and home. One woman said that, when her husband was first admitted to ICU, she'd phoned her mother, who'd then contacted her neighbours and asked if they could look after her home and pets while she stayed at the hospital. Another woman described how, when her best friend ended up in ICU after complications during surgery, she had had the task of finding her fifteen-year-old son, who'd gone away on holiday.
People recalled how quickly news of the critical illness or injuries had spread 'through the grapevine'. Sometimes relatives or friends had turned up at the hospital or had phoned them for information because they'd been concerned and worried themselves.
Once they'd started telling other people, many said they'd kept them updated on the patient's progress, often daily. Many had texted and emailed relatives and friends once a day because texting and emailing had allowed them to send just one message to many people in one go. Most said they hadn't wanted to repeat themselves over and over again and a daily text or email enabled them to pass on information to others quickly and efficiently, allowing them to spend more time with the patient rather than on the phone.
One woman said she'd texted a friend every day while her partner was in ICU and this friend had then contacted and updated everyone else. Another said that, although she'd sent daily texts to update family and friends, these messages were often misinterpreted because other people hadn't understood how seriously ill and debilitated her son had been.
Many people updated others over the phone, sometimes while they were at the hospital, though usually after getting back home. Some had lots of calls to make after visiting ICU, others lots of messages to return, and many said the phone hadn't stopped ringing once they were back home. Most people had found it exhausting making lots of phone calls every day. One woman described phoning her daughter every morning and every evening because she lived a long way away and was unable to visit her critically ill grandmother. Then having done this and given her an update on her grandmother's progress, she still had to contact other relatives. Many people said they'd found this extremely difficult because they'd been emotionally exhausted, worried and stressed after sitting at the patient's bedside all day. One woman said she'd often unplugged the phone after a long day at the hospital just to have some peace and quiet while she'd had something to eat.
Some people said they'd found it difficult to sleep at night, worried that the phone might ring and they'd have to return to ICU because the patient had deteriorated. One woman described how the ICU nurses had given her a pager so she didn't have to panic each time a call came in on her own phone, knowing that if the hospital did need to reach her they would call on the pager. She said this was a great help.
During this extremely traumatic, uncertain time people sometimes felt they couldn't face having to go through everything all over again with someone new so, even though the caller meant well, their calls sometimes felt upsetting and intrusive.
One woman said that after visiting her husband in ICU she'd had a two hour drive back home, usually after midnight. As soon as she'd leave ICU she'd have lots of phone calls and messages on her mobile phone, and sometimes returned calls while driving, using her hands-free kit.
Updating others had been particularly difficult for people because, often, there'd been no change or very little change in the patient's condition, particularly in the early stages. Some said the ill person had improved and deteriorated so often they hadn't known what to tell people. A few said they'd emailed or written to the ill person's friends, thinking that the patient had had very little time left, and had felt uncomfortable about having done so because the patient had improved the following day. People often hadn't known what to tell others when the patient's condition had changed so much from hour to hour or day to day, or they didn't know what the future had held. Sometimes they were surprised and pleased to hear from people the patient had been out of touch with for a long time.
People also needed moments when they could be alone to think in peace, to take care of things at home, recharge or deal with their feelings. One woman said she hadn't told any of her own friends about her brother's illness until he'd started improving because she hadn't wanted to talk about something so distressing all the time.
Some people had found it helpful to leave a recorded message on their answering machines so that, whenever people called, they'd hear an update. One woman said, as well as leaving an update on her answering machine, she also left notes on the door so the postman and milkman would know.
A few people said they'd needed to talk over the phone after visiting the hospital all day because the calls to or from other people had helped them feel supported. Many said the calls and cards wishing the patient well had shown them just how much support they'd had around them at this very stressful time (see 'Sources of support in ICU').
When someone is critically ill in intensive care, one relative or close friend is designated next of kin and will be given a full update when they phone the ICU. This person is expected to pass on updates to other people who will not have been given much information when they have phoned in. When away from the hospital, many people had relied on nurses to ring them if there'd been any change in the patient's condition. Some said they'd often phoned ICU to get a quick update before going to hospital or phoning others. Mostly this worked well and people said that the nursing staff had always been helpful, whatever time of the night or day they happened to call. A few people did say there'd occasionally been a bit of confusion in who the designated person had been and, when they'd phoned ICU for an update, they had found it difficult to get information from nurses. One woman said her father had been so distressed when her mother had been critically ill that he withdrew and gave them very little information. When she had phoned ICU for information, some nurses had been helpful but others had refused to give information to her as she was not the designated person.
Last reviewed November 2010.
