Preparing for your planned admission to the Paediatric Intensive Care Unit
This page is for you to find out more about what it will be like when you have a planned admission to the Paediatric Intensive Care Unit (PICU).
What is PICU?
PICU stands for the Paediatric Intensive Care Unit. This is a specialist ward where children and young people are cared for when they need support from the intensive medical and nursing care teams. On PICU every patient will have at least one nurse looking after them. This is due to the high level of care and support required. The nurse will make sure the patients they look after have everything they need.
You don't just need to read about PICU, you can come and have a look around the unit and talk to staff before you stay. That way you can see what happens on PICU. You can arrange this by talking to your consultant, clinical nurse specialist or by calling the PICU family liaison nurses on 020 7829 6723.
Why am I going to stay on PICU?
Children and young people come to stay on PICU for different reasons. Sometimes they might need to have extra support with breathing and/or specialist equipment. Other times they might need to stay on PICU for a short time after they have an operation to make sure they are okay and ready to be moved to another ward for recovery.
How long will I be on PICU?
This varies for everyone. It's a good idea to speak to your nurse about this.
What's different about PICU?
You might have already spent some time on a different ward or visited one of the wards at the hospital. There are lots of things which are similar to other wards. There are still lots of doctors, nurses and other staff who will be looking after you throughout the day, but on PICU you will see the staff around more of the time.
Professionals from other wards who you already know might visit you on PICU too, but you'll meet other doctors and nurses too.
There is a space in the booklet about preparing for PICU to where you can record doctors names and details. You can download this booklet before you arrive.
What will happen while I'm on PICU?
When you come to intensive care after your operation, you are likely to need a tube that will help you with your breathing. This is quite normal after a long operation, or for young people that have breathing problems before their surgery. The tube will either be in your mouth or in your nose. This is called intubation. The tube may be attached to a breathing machine called a ventilator. This is called ventilation. When you have a tube in you will not be able to speak but try not to worry, the nurses and your family will help you to communicate by writing things down or you can point at what you want.
Having a tube in your nose or mouth does not hurt but it may feel a bit irritable. To prevent any distress or discomfort from this you will be given medicines via your veins which will make you sleepy and control any distress and discomfort. This is called sedation. The doctors and nurses will also help with any of the discomfort or pain that you may possibly feel.
Can people visit me on PICU?
Yes. Usually your closest family will be with you when you first wake up on PICU. If you have brothers and sisters they can also visit you when you feel ready for it. Usually only three people can be by your bed at any time so it doesn't get too crowded. Friends can also visit once you are on the mend.
Sometimes young people like to have lots of visitors, others just want one or two of their closest family. Let the nurse know who you would like (or not like) to visit.
Can I eat and drink when I'm on PICU?
While you have a tube in you will not be able to eat or drink by mouth but you might have a feeding tube in your tummy to ensure that you're not hungry.
Things to think about before your admission
Things to bring in
You will have a good idea about the things you will find helpful to have with you. Other young people have said these things can be helpful:
- A favourite DVD
- Books and magazines
- Computer games
- A list of things you would like PICU staff to know about you
- Personal care items like shower gel, deodorant, hairbrush, hair bobbles, toothbrush and toothpaste (remember on PICU you can choose who you would usually like to help you with your personal care)
- Clothes: underwear, pyjamas (ones with buttons at the front are ideal), normal clothes for during the day, slippers (for when you feel well enough to walk around the unit)
- Favourite pillow, blanket, toy, or a lucky mascot
- Photos of your family, friends or pets!
- Earplugs and/or a sleep mask (there is always a low level of lighting on PICU, even at night time so some people find it hard to sleep)
- Our information document. You can download it.
Who you'll meet on PICU and what they do
There are lots of different people you might meet on PICU.
Doctors and nurses
You will meet a number of different doctors and nurses when you stay on PICU; sometimes it might seem like you are meeting new staff every day! All the doctors and nurses on PICU are part of a team and so will be working together.
Family liaison nurses
These are special nurses who you may meet on PICU or if you come and visit before. They won't be wearing uniforms like other nurses. Their job is to meet with all the families and find out about how you and your family are managing. They can also help with any questions you may have about being on PICU and arrange for you to meet with the psychologist or play specialist.
A play specialist is someone who prepares children and young people for all sorts of procedures and operations, provides distraction during things like blood tests and dressing changes and provide things to do when you are feeling up to it or you are bored. They can also help if your brothers and sisters and friends want to visit. Remember to bring in your favourite stuff like music, DVDs and books!
At GOSH, there are school teachers who can help young people continue with their school work while they're in hospital. This is different for everyone. Someone people stay here longer so school is more important. The key thing to remember is to not worry too much about missing schoolwork, that's what the school teachers are here to help with.
The physiotherapists work alongside the doctors and nurses. Physiotherapy (or physio) is an important part of PICU as it helps your lungs clear while you are using a ventilator. This type of physio is often called chest physio. The physio will help you take deep breaths and cough to remove phlegm on your lungs. This is a normal part of caring for someone who is on a ventilator and helps to reduce the amount of time you need to stay on a ventilator. If you need it, the physio may also keep an eye on how your arms and legs are moving and help you to get mobile again.
A psychologist is not a medical professional and so cannot prescribe any medication. Their job on PICU is to support children and parents on the ward. They offer support and help with any thoughts you might have about being on PICU. This could be helpful if you are feeling worried, scared or sad, or if you would just like to meet with someone outside of your family. Don't worry if you are having trouble speaking, you can still have a conversation with a psychologist by writing things down. The psychologist can also talk to the doctors and nurses on your behalf if there is something you would like done differently.
Social worker and family support worker
There are two social workers on PICU who are there to help you with any problems you may be having while you are at GOSH or at home. Sometimes this might be about making sure you and other members of your family are feeling safe and secure, or maybe to help ensure your views are heard by the doctors and nurses or your own family. Social workers and family support workers can also help with any advice you and your family might need about money, school or other difficulties. You can always talk to a social worker in private if you are worried about anything, just ask the nurse looking after you.
Adolescent clinical nurse specialist
Our adolescent clinical nurse specialist provides independent support for anyone aged 11 or above wherever they happen to be in hospital. He is available if you want someone to talk to about anything at all. It doesn't have to be related to your treatment or being in hospital. It could be about school, relationships or anything else.
The chaplains are a friendly team who will come and chat to see how you are doing. They are not medical but are interested in the whole of you, about how you are feeling, about things and and people that matter to you, the things sometimes called 'spiritual'. On our team we have chaplains from different faiths, so if you have a faith we can pray with you or talk about these things as well. We look forward to meeting you.
Download our guide if you'd like to read top tips from young people who have stayed on PICU, the daily routine, glossary of useful words and a feedback form.