Information for Families

Arriving at the ICU

The Intensive Care Unit at Chris O'Brien Lifehouse is a specialised ward caring for patients who are seriously or critically ill. When you first walk in, it can feel overwhelming — there are many machines, alarms, and staff moving quickly. This is normal.

Please speak to the nurse at the ICU station when you arrive. They will let the bedside nurse know you are there and guide you to your family member. You will not be left to navigate it alone.

What you might see

Patients in the ICU are often connected to a number of machines and lines. These might include:

• A breathing tube (endotracheal tube) or tracheostomy — placed through the mouth or neck into the airway, connected to a mechanical ventilator that breathes for the patient. If your loved one has this, they will not be able to speak, but can often still hear you.
• Monitoring leads — sticky pads on the chest connected to a screen showing the heart rhythm, blood pressure, and oxygen levels continuously.
• IV lines and catheters — thin tubes going into blood vessels (sometimes in the arms, neck, chest, or groin) used to give fluids, medications, and nutrition, or to monitor pressures inside the heart.
• A urinary catheter — a tube draining urine, which allows the team to monitor kidney function closely.
• Drains and dressings — depending on the patient's condition or recent surgery.

Alarms on the monitors go off frequently — most are not emergencies. The bedside nurse responds to every alarm and can explain what each one means.

Visiting

We encourage family visits — your presence matters. Hearing a familiar voice is comforting even for patients who appear to be asleep or sedated.

Visiting hours

Please check current visiting hours with the ICU directly, as these may vary. Generally, visits are welcomed at most times of day but may be briefly paused during medical rounds, procedures, or shift handovers. Staff will always let you know when it is a good time to come in.

How many visitors at once

To protect patient privacy and allow the team to work safely, we usually ask for no more than two visitors at the bedside at a time. Children are welcome with staff guidance and parental presence — please ask staff if you are unsure.

How to help during your visit

• Talk to your loved one calmly and naturally — tell them who is there, what day it is, and simple reassuring things. Even if they cannot respond, they may be able to hear.
• Gentle touch — holding a hand or a gentle touch on the shoulder can be comforting.
• Bring familiar items — a photo from home, a favourite piece of music played softly on a phone, or a familiar scent can all help with orientation and comfort.
• Try to keep the environment calm — avoid distressing conversations at the bedside.

Communicating with the Team

We want to keep you informed. Here is how communication typically works in our ICU:

The bedside nurse

Your loved one has a dedicated nurse at or near their bedside at all times. The bedside nurse is your first point of contact for day-to-day questions about care, comfort, and what is happening right now.

Speaking with a doctor

The intensive care doctors (intensivists) conduct formal rounds all day. If you would like to speak with the doctor, let the bedside nurse know — they can arrange a time for a family meeting or a brief update. You are welcome to ask questions at any time.

Nominating a family spokesperson

If there is a large family, it helps enormously to nominate one or two people to receive medical updates and relay information to others. This reduces the burden on the team and ensures everyone gets consistent information.

Medical decisions

In the ICU, decisions about treatment are made by the medical team in consultation with the patient (where possible) and with family. We will always explain options, answer questions, and take your views seriously. If you are ever uncertain about a plan or feel you need more information, please ask — there are no silly questions.

The SDM Navigator website has excellent plain-language resources — including guides and multilingual videos — to help you and your family share in decisions about treatment with the medical team.

Worried your loved one is getting worse? REACH out

Refer to your bedside nurse initially — they are best placed to answer your concerns quickly. If you are still worried after speaking with them, you can contact REACH — a NSW Health program that gives patients, families and carers a direct way to escalate concerns further. You know your loved one best, and you may notice a change before anyone else. REACH stands for:

• Recognise — you notice a worrying change in your loved one's condition.
• Engage — talk to the nurse or doctor caring for them and tell them exactly what concerns you.
• Act — if you are still worried, ask the nurse in charge for a Clinical Review.
• Call — if your concerns have not been addressed, call the REACH line on (02) 8514 1118 (or extension 41118 from any hospital phone).
• Help is on its way — a senior clinician will come and review the patient.

You will never be criticised for raising a concern. REACH exists because families are often the first to notice when something is wrong.

Understanding Common ICU Treatments

Mechanical ventilation

A ventilator is a machine that breathes for the patient when they are unable to breathe adequately on their own. Patients on a ventilator have a breathing tube placed into the airway. They are given sedation and sometimes pain relief to keep them comfortable. Being on a ventilator is not painful. As patients improve, the level of support from the ventilator is gradually reduced until they can breathe on their own.

Sedation

Many ICU patients receive medications to keep them calm, comfortable, and sometimes asleep. The level of sedation is carefully adjusted — some patients are kept deeply sedated, others are lightly sedated and can open their eyes and respond to simple commands. Sedation is not the same as being unconscious or in a coma, and the level is regularly reviewed.

Dialysis (renal replacement therapy)

When the kidneys are not working properly, a dialysis machine can take over their function — filtering waste products and excess fluid from the blood. This is often a temporary measure while the kidneys recover. ICU dialysis is continuous and looks different from the dialysis machines used in outpatient kidney clinics.

Vasopressors and inotropes

These are medications given through IV lines to support blood pressure and heart function. You may see several infusion pumps running at once — each controls a different drug at a precise rate.

Looking After Yourself

When a family member is seriously ill, it is easy to forget your own needs. But you cannot support your loved one — or make clear-headed decisions — if you are exhausted, hungry, or overwhelmed.

• Sleep and eat regularly. The ICU team will contact you if there is a significant change. You do not need to be there every hour of the day.
• Ask for support. Chris O'Brien Lifehouse specialises in integrated care, with many allied health teams who work to support the needs of both patients and their families. Social workers are available at the Lifehouse to support families during difficult admissions. Ask the ICU staff to arrange a meeting if you would like one.
• Accept help from others. Let friends and family bring meals, help with childcare, or handle practical tasks so you can focus on being present.
• Give yourself permission to feel what you feel. Fear, grief, anger, hope — all of these are normal responses. You do not have to be strong all the time.

After the ICU

Recovery from a critical illness takes time — often much longer than patients and families expect. Leaving the ICU is a positive step, but it is not the end of the journey.

Transfer to a general ward

When patients no longer need intensive monitoring and support, they are transferred to a ward at the Lifehouse and back to the care of their primary team. This can feel unsettling — the ratio of nurses to patients is lower on a general ward. But it means your loved one's condition has stabilised and they no longer need the level of intervention the ICU provides.

Post-ICU syndrome

Many ICU survivors experience lasting effects after discharge — physical weakness, fatigue, difficulty concentrating, anxiety, depression, or disturbing memories of their time in hospital. This is known as Post-Intensive Care Syndrome (PICS) and is very common. It is not a sign of weakness. If you or your loved one are experiencing these effects, please speak to your GP or treating team about support options.