When your child is admitted to the intensive care units at GOSH

PICU (Seahorse), NICU (Dolphin), CICU (Flamingo) and Alligator Ward are units for babies, children and young people requiring intensive care. This page explains a little about the Paediatric Intensive Care Unit (PICU), Neonatal Intensive Care Unit (NICU), Cardiac Intensive Care (CICU) and Alligator Ward at Great Ormond Street Hospital (GOSH). We hope that this will help you at this difficult time.Both PICU and NICU are on level 4 of the Variety Club Building (VCB), and CICU and Alligator Ward are level 4 of the Morgan Stanley Clinical Building (MSCB). When you get to level 4 (either by lift or stairs) the units are
clearly signposted.

Your child will still need you while they are in the unit and we want to help you look after them as much as you can. It will help us to know about your child’s character, habits, likes or dislikes and any nicknames you have for them. You can also bring in a recent photograph of your child to be put up by their bed in the unit.

Your child may be sedated, but they may still hear and recognise familiar voices and sounds. We encourage you to read or talk to your child. You could also play favourite CDs or specially recorded messages. If your child has a favourite toy or comforter, it can be placed close to them. There are stereos and portable DVD players available on request.

Your child may need help with their breathing. If so, a piece of equipment called an endotracheal tube will be passed through the nose or mouth and into your child’s airway. They will be sedated so it will not hurt. Once it is in place, the tube will be connected to a ventilator. This will stay in place until your child can breathe without it.

One of our most important concerns is that no child on the unit should be in pain. We therefore give all our children regular and/or continuous doses of sedation and pain relief to make sure they stay sleepy and pain free.

Staff are required to fully inform you about and obtain your consent for any procedure they carry out on your child. In the busy environment of an intensive care unit, it may not always be possible to do this before the procedure takes place. The staff will always explain to you what they are doing and why.

However, by agreeing to the admission to the unit, it is understood that you consent to the routine intensive care procedures that are in the best interests of your child and their treatment. If you do not agree with this statement, you must inform your child’s consultant or the nurse in charge as soon as possible.

The medical care of your child will be led by senior doctors called consultants. If you would like to speak to one of the consultants, please let the nurse looking after your child know.

The nursing team includes a matron, sisters and charge nurses, senior staff nurses, staff nurses, health care assistants and students at various different points in their nurse training. Children on the unit are usually nursed on a one-to-one basis by a qualified nurse. In certain instances, they may be cared for by a student but they will always be overseen by a qualified nurse.

There may come a time just before your child is transferred out of intensive care that the nurse looking after them will also be looking after other children as well. This is perfectly normal and a sign that your child is getting better and will soon be able to go to a ward either within GOSH or back at your local hospital.

The multidisciplinary team based on the unit who are also involved in your child’s care include physiotherapists, a pharmacist, dietitian, play specialist and housekeeper. Other specialist teams may also be involved in your child’s care and they will visit the unit to help treat and advise on patient care. We also have a team of volunteers that work in intensive care areas to support staff and families.

The intensive care units have their own psychosocial team that comprises family liaison nurses, psychologists, social workers, a play specialist and chaplains. They visit the unit on a daily basis and try to see and support as many families as possible and help with the stress of having a child in intensive care. The team will try to help you with any practical or emotional difficulties that can occur while your child is an inpatient. You can ask
your child’s nurse to arrange a meeting with any member of the psychosocial team.

You are welcome to telephone the units at any time. Anyone who has an infection should not visit until they are better. If in doubt, please speak to your bedside nurse or the nurse in charge.

You can see your child whenever you want to although parents and other visitors have to leave the unit when emergency procedures are being carried out. The morning ward round is a teaching round so there may be more members of staff discussing your child than at other times, therefore we may ask all parents to leave. Your child’s nurse will arrange a time for you to speak to the doctor after the ward round so that you can discuss your child’s progress.

We ask that you are present when visitors arrive to see your child. Please limit the number of visitors to a maximum of three at any one time (including the parents). Other visitors will be asked to wait outside the ward. Your child’s brothers and sisters are welcome to visit up to 9pm but should always be supervised by a responsible adult. After 9pm, parents should be the only visitors.

Parents are allowed to visit anytime they want, although we do suggest you take regular breaks. Other visitors such as grandparents and other family members must visit between 3.30pm and 7.30pm on weekdays and between 12 midday and 7.30pm on weekends or Bank Holidays.

Only two people (including the parents) are allowed at the bedside at any one time. Other visitors will be asked to wait outside the ward. Brothers and sisters are welcome to visit but must always be supervised by a responsible adult.

GOSH guarantees somewhere to stay for both parents (or two adults) when a child is in an intensive care unit. As parents are unable to stay by the bedside on intensive care, this will be in one of the Family Accommodation units in various places near the hospital.

All accommodation is self-catering, but there are plenty of cafés and shops in the local area. Please ask for a copy of ‘Around GOSH’ for details. Bed linen and towels are provided free of charge in all rooms. If you want fresh linen or towels, please put them outside the room in the morning.

Due to the limited amount of accommodation available, parents may be asked to relocate if there is a change in their child’s condition. For example, if your child recovers enough to be transferred to another ward at GOSH, we will only be able to offer accommodation to one parent.

For incoming calls, you may use the direct telephone lines to the unit (details at the end of this leaflet). If friends or relatives call, we will take a message but we ask that these calls be kept to a minimum. Nurses cannot give information about a patient to anyone except his or her parents. There are areas on level 4 where you are permitted to use mobile phones and these are clearly marked. Please keep mobile phones on silent and take any calls outside the unit.

There is a restaurant on the ground floor (Level 2) of the hospital called ‘The Lagoon’. Opening hours are clearly displayed outside. There are cold water drinking fountains on each of the units.

On PICU and NICU there are facilities to make hot drinks in the Parents’ Lounge. Please do not take hot drinks on to the unit or into the Family Lounge.

On CICU you can use the family area to make yourself drinks or something to eat.

Wherever possible we will dress your child. You are welcome to bring in his or her own clothes, but please label them clearly as we cannot take responsibility for them while they are in the hospital. We encourage the use of toys in the intensive care units. Toys which can be wiped clean are preferable. We have a small selection but feel free to bring in a few of your child’s own toys, especially anything that is a particular favourite, but again make sure it is labelled. Please bring in your child’s toiletries, including their toothbrush and toothpaste.

When a newborn baby has been admitted, the mother may be resident only after being discharged from maternity services. This is because there is no medical cover for adults in the hospital. Before discharge, she is able to visit if well enough. When mothers are staying at GOSH, there are facilities to start expressing breast milk and mothers are supported by the neonatal nurse advisor as required. Newly delivered mothers can also be seen at the midwifery clinic if necessary, which is held twice a week in the hospital. Food vouchers for breastfeeding mothers are also available.