ICUsteps
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Moving from critical care to general ward

Good night all :)

My dad was rushed to the ITU just over five weeks ago with a huge variceal bleed. He was in ITU for about 3 and a half weeks and then moved to HDU for a week and a half. He is currently still in HDU but is no longer on life support and is generally doing well (which I'm grateful for every day, as I really didn't think we would get here). However we received a phone call about an hour ago (10pm our time) from the HDU sister informing us that they were moving my dad to a normal ward. We had a few concerns about this, namely:

1. When my dad was rushed to ITU with his bleed he was on a general ward - however he wasn't monitored closely enough which is why he suffered the huge bleed in the first place, and the condition that causes this bleeding is not resolved (it could happen any time).

2. The ward they want to move him to is a surgical ward that is at the other end of the hospital to the ITU - we were told a few days ago that he would be moved to a medical ward (preferably gastro or cardio, as he had problems with both of these things whilst in ITU) very close to ITU, as the underlying cause for his bleeding still is not sorted and theoretically it could happen again, which would be devastating.

3. We had no forewarning that the move would happen today or anywhere close to today, no monitoring or future care plan is in place or has been passed along to us, and basically we have no clue what the next step is - and seeing as he was on ITU for quite a while and his condition still has not been resolved, I'm disappointed by this. ITU/HDU has been incredible and absolutely saved his life, but I just want to know he will continue to progress.

My problem isn't that he is being moved to a ward - we knew it would happen at some point and it's a good sign that he is progressing. However, we want to make sure it is the correct ward (the nurses/sisters admitted to us they are being pushed for room in HDU and that the surgical ward is not appropriate for dad) and that it is close to ITU, and that a plan is in place so we are ensured that he is being monitored correctly. If he is at risk of bleeding again it will show in his hemoglobin and blood pressure levels, so these need to be taken very regularly - if not it could be fatal. The lack of plan is scary to me :( he has been through so much and I love him and just need him to be okay. My sister was very firm on the phone to HDU and they are no longer moving him tonight, and will be discussing it further tomorrow. We've made a big list of things to talk about with the consultant/HDU and the new ward sisters, but I was wondering if you have any advice or experiences to share regarding the transition between HDU/ITU/ICU to a general ward?

Thanks in advance :)

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Have a look at a post by @KinnyL from a while back - hope it goes ok with your Dad

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Wow, so much useful info - thanks! Although most experiences seem to be on the negative side, sadly :(

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I'm afraid all this moving around is common in the NHS. It's not good for the patient, and very stressful for relatives too. During my 4 weeks in ICU, I was moved twice (once at 4am) and when my family came to visit the next day, ICU staff could not tell them which ward I had been moved to. They thought I had died.

I was discharged from ICU to a mainstream surgical ward, on a Christmas Eve, and at 9pm my jejeunostomy tubes fell out. It was pure luck that one of the surgical team who had been looking after me was still on duty and re-fitted the tube. Otherwise - Christmas, holidays and weekends are not well staffed - I might not have had any feed for several days. I was already very malnourished.

You are right to want to know details of the recovery plan for your dad, and where it will take place. Good luck and I hope he continues to do well.

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I had Sepsis, pneumonia, MRSA, 2 grade 3 Comas, my kidneys failed so was on dialysis and was given a 1-2% survival rate. My family were told I wouldn’t survive and if I did survive CCU, then I would be taken to a hospice. After waking from the 2nd Coma, I was moved into a single room on a general ward. I wasn’t really fully awake until I’d been in the room for nearly a week. It’s now almost 4 months since I left the hospital and am slowly recovering. I hope your Dad continues recovering well xox

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