Health care team
Doctors
Critical care intensivists
• Doctors who specialize in critical care, also referred to as “attendings” or “attending doctor” and oversees other doctors like fellows, residents and advanced practice providers depending on the location.
• Meet with the health care team every day to plan care.
• For hospitals that are not located in Grand Rapids, they may be seen by the intensivist virtually.
• May supervise other providers such as fellows, residents and advanced practice providers depending on location.
Advanced practice provider
• An advanced practice provider may be a nurse practitioner (NP) or physician assistant (PA).
• Trained in patient care and have a graduate degree.
• May prescribe medications, testing and help form the treatment plan.
• May perform procedures as directed by the attending doctors.
• Work with and are closely supervised by the doctors.
Nursing team members
Registered nurses (RN)
• May be caring for one to three patients at one time.
• Work closely with the doctors to find and treat problems.
• Give medications and may assist with procedures.
• For hospitals that are not located in Grand Rapids, they may also be seen by a critical care nurse virtually.
Nursing technician
• Help nurses provide care.
• Help with bathing, eating, dressing and moving the patient.
Imaging technologist
• Trained in X-ray technology, works closely with nursing and physician teams to provide imaging of your internal organs.
• Portable X-ray machine may make loud noise when entering room and your family may be asked to step outside while you are imaged.
Allied team members
Respiratory therapists
• Work closely with the doctors and nurses throughout the day and night.
• Provide care for your loved one’s lungs and airway.
Pharmacists
• Work with providers to help choose the best medicines and monitor the medicine’s effects.
Nutrition services
• Nutrition services team members bring your food trays.
Clinical nutrition
• Registered dietitians assess nutrition needs and place the best diet order.
• Registered dietitians may also order alternative nutrition, such as tube feedings, if needed.
Laboratory technicians
• Draw blood for lab testing.
Patient transport
• Bring your loved one to their appointment or test within the hospital.
Environmental services
• Cleans the room and other areas.
Physical therapists
• Make a plan to help increase muscle strength, balance, and endurance.
• Do stretching and range of motion activities to help with movement.
• Help with planning for leaving the hospital.
Occupational therapists
• Help with planning for leaving the hospital.
• Help with activities like bathing, getting dressed and eating.
• Do stretching and range of motion activities to help with movement.
Speech-language pathology therapists
• Assess speech, language, swallowing, memory and thinking.
• Help to improve speech, language and swallowing if needed.
• Help with planning for leaving the hospital.
Medical social worker and care managers
• Help with financial, legal and insurance questions.
• Refers to resources in the community.
• Lends emotional support.
• Help with the move to other facilities if needed.
Students
• Corewell Health is a teaching hospital and many types of students train here.
• All students are closely supervised by a professional team member.
Delirium
Delirium is a condition where someone becomes confused. It comes quickly and can last hours to days. Patients in the ICU are at risk for delirium because of the medications they need to stay comfortable, their sleeping cycle is not regular and they are not as active. Signs of delirium include confusion, seeing or hearing things that are not there, being quiet, irritable and they may not know why they are in the hospital or what day it is. The medical team is looking for signs of delirium and trying to prevent it. This is done by keeping your loved one active, staying on a regular schedule and reminding them what day and time it is. Day is best to keep the blinds open and take short naps. Evening is best to close the blinds and keep the noise down. Delirium tends to improve with time. You can help by speaking clearly, using clear directions and reminding them what day and time it is.
Mobility
It is important that your loved one stays as active as possible while they are in the ICU. Some patients can walk and others may only be able to take a couple of steps to sit in the chair. Some may need help moving while others may not. If moving is painful, we have medications and other methods to keep them comfortable. Staying active helps to prevent infections (like pneumonia), delirium and helps them to heal.
Going home
Transferring
At some point, your loved one may be able to transfer to another floor in the hospital. They would then be cared for by the nurse on that floor. This nurse will have more patients to take care of than ICU nurses. This is typically a step forward toward going home.
Going home
Some patients go home when they leave the hospital. Others go to a rehabilitation unit within the hospital, a rehabilitation center outside of the hospital or another facility. They may have a physical therapist, occupational therapist, speech therapist or visiting nurse come to their home. Care managers and social workers help to make this transition as smooth as possible.
Post intensive care syndrome (PICS)
PICS is a condition that can affect thoughts, emotions, thinking and body. It may happen when someone is in the ICU and can continue after they go home. Signs that they are experiencing PICS include weakness, this may last for a year or more. They may need help bathing, eating and getting dressed. They may have difficulty remembering things, paying attention or concentrating which can impact their ability to go back to work. Your loved one may have difficulty sleeping, have nightmares, feel anxious or depressed. It is possible they may experience “post-traumatic stress disorder” or PTSD symptoms. If you notice these signs in your loved one, please talk to their doctor.
PICS may also affect family members. Due to the stress of caring for their loved one, family members may also experience depression, anxiety and post-traumatic stress disorder. It is important that family members take care of themselves. Do this by exercising, eating well, getting rest. There are social workers, care managers and spiritual care available to help. There is also a journal, note taking area at the back of this booklet.
Visitor expectations
• We ask that patients give any items of value to their family members to take home.
• Please keep voices low to promote a healing environment.
• Choose one or two people to get regular updates. These people can update the rest of the family so that the nurse can focus on caring for your loved one.
• Please do not call during 7 a.m. to 8 a.m. or 7 p.m. and 8 p.m. to get an update as the nursing team members are giving report to the oncoming shift.
• You may be asked to step out of the room during patient care.
• Please do not visit the hospital if you are not feeling well.
• It is extremely important that you wash your hands when entering and exiting your loved one’s room to prevent the spread of infection.
• If your loved one is in a room due to an infection, you may be asked to wear gloves, gown, mask or eye protection when entering the room. These will have to be removed prior to leaving the room.
• Please do not wait in the hallway as it can become crowded.
• Toilets in patient’s rooms are for patient use only, please use the bathrooms in the waiting room.
• The doctors, nurse practitioners and physician assistants do not have set times they will see each patient. Please be patient while we wait for the team to arrive, it is best to have questions written down so you can ask when they come.
• Visiting hours are set to meet the specific needs of the patient, some patients may need time without visitors in order to promote healing.
• Live plants and flowers are not allowed in the ICU.
• Mylar balloons are allowed.
Tips
• Keep a diary for notes and questions that may come up.
• Take breaks away from the hospital. Take turns with other family members, so you can get some time away.
• Shower, eat, sleep-this is important for you to keep healthy and alert.
• Choose someone to handle things at home when you are unable to leave the hospital.
• Bring pictures of your loved one.
• Use Carepages (or other social networking media) to help take away the stress of updating everyone.
• Leave a message on your answering machine or voice mail about how your loved one is doing.
• Dress in layers. Hospital rooms can be cold.
• Always keep personal items with you.
• To create a caring, healing room, limit the number of personal belongings. The area around the bed must be kept clear.
Amenities
Accommodations
Corewell Health Renucci Hospitality House
• Located by Corewell Health Grand Rapids Hospitals - Butterworth Hospital in Grand Rapids, MI.
• Call 616-391-1790 or visit spectrumhealth.org/renucci-house.
Grand Rapids hotel information
• Unit secretaries have a list, they sit at the front desk.
Corewell Health hospitals (not located in Grand Rapids)
• Ask your nurse about accommodations in the area.
Concierge service (Grand Rapids)
• Helps with information on local hotels, discounts, restaurant options and transportation services.
• Available 24 hours a day, seven days a week.
• Contact information: 616-267-1234 or 888-208-8075.