St. Joseph Health Regional Hospital Intensive Care Unit

The Intensive Care Unit (ICU) is a special section of the hospital equipped with advanced medical technologies and equipment, designed to care for critically ill or injured patients. Focused care is provided to patients in the ICU by a specialized healthcare team. Critical Care Unit (CCU) is often used interchangeably with ICU. Some ICUs are specialized to care for a certain population of patients. At St. Joseph Regional Health, we take care of a wide range of critical patients including Respiratory, Cardiac, Surgical, Trauma, and Neuro patients.

What to expect while in the ICU: Visitors to the ICU should prepare to see tubes, wires, machines, and monitors attached to the patient. Many of the machines and devices have alarms that sound periodically, which the staff are monitoring at bedside and at the nurses’ station.

Visiting hours and information

We encourage family members of patients in the ICU to come visit us, but we ask that you please follow these guidelines:

• Family members of patients are welcome any time except during shift changes, which are from 6:30 - 7:30am and 6:30 -7:30pm.
• You may be asked to leave the ICU based on procedures, events, changes in the environment, or a patient’s need to rest.
• If you have come to visit the ICU but have temporarily stepped out, we ask that you please call us before re-entering.
• Children under the age of 10 are not allowed to visit the ICU. This is to minimize the risk of transmitting infections to both patients and children.
• Please limit visitors to two persons at a time.
• To reduce the risk of infection, flowers, fruits, and live plants are not allowed in the ICU.

Information for Visitors & Visitation Guidelines

• Our team is here to provide patients and loved ones with the best medical care and service. Families play an important role in helping the ICU team provide the best care for patients.
• Quiet time
• Visitor restrictions
• Gifts (what can and cannot be brought)
• Visitor hygiene importance
  • Infection prevention
  • Isolation precautions

• Unit phone number- 3 Suites A, B, C
  • Suite A (Rooms A1-A12) 979-776-2545
  • Suite B (Rooms B1-B12) 979-776-2586
  • Suite C (Rooms C1-C12) 979-776-2579

• PIN Codes- The federal Health Insurance Portability and Accountability Act (HIPAA) mandates that healthcare organizations control the release of confidential patient information. In order for us to comply with the HIPAA law, a Personal Identification Number (PIN) will be provided to the patient or decision-maker upon admission to the hospital. This code is required to receive health information about the patient. It is recommended to limit PIN code access to one or two family members who have been designated as “persons to notify” by the patient.

About the Team

Meet the ICU Leadership Team

• Greg Emmons, MSN, RN-BC
  • Market Director of Critical Care Services
• Wendy Stratton, BSN, RN
  
  • Nurse Manager
• Dana Black, MSN, RN, NPD-BC, CCRN
  
  • ICU Clinical Education Specialist
• Ede McAbee, MHA, MSN, RN, CCRN
  
  • ICU Administration Support Specialist

Meet the Intensivist Team

Every patient in the ICU is seen by an intensivist. The intensivist works closely with the attending physician and other specialists to establish an individualized plan of care for each patient in the intensive care unit. Our intensivist team is comprised of board-certified physicians who specialize in pulmonology and critical care medicine. The physicians are supported by physician assistants (PAs) and nurse practitioners (NPs) who specialize in critical care to ensure round the clock coverage and continuity of care.

Who are the members of the ICU patient care team?

• Critical Care Nurses provide the majority of direct patient care. Critical care nurses are registered nurses (RN) with special training to ensure competency to care for patients in the ICU. The RN assesses, monitors, and treats each patient according to their plan of care.
  • Certified Nurses
    • Several of our nurses hold a specialty nursing certification, such as Acute/Critical Care (CCRN) and Progressive Care (PCCN) through the American Association of Critical Care Nurses. Nursing certification is a validation of knowledge and expertise as well as a demonstration of our nursing staff’s commitment to providing high-quality patient care.
• Patient Care Techs (PCT) assist with patient care under the direction of the nurse. They assist with mobility, bathing, feeding, and other activities. 
  
• Respiratory Therapists (RTs) work with the intensivist team and nurse to protect the patient’s airway and improve the patient’s breathing. The RT has special knowledge and training in secretion clearance, ventilator support, and respiratory medications.
• Pharmacy carefully reviews all medication orders and offers their expert knowledge on the appropriate medication and dosage when needed. The ICU has a dedicated pharmacist who has specialized knowledge in critical care medications.

Who else provides care and services to patients in the ICU?

• Case Management/Social Work works with the patient, family, and care team to determine what needs the patient may have once they leave the hospital.
• Palliative Care services are available to patients and their families in the ICU. Palliative care works with each patient to ensure the care and treatment being provided is in line with that patient’s goals. Palliative care can assist with advance directives, understanding disease process and prognosis, symptom management, and end of life care.
• Spiritual Care is available to all patients, families, and staff in times of crisis, as well as routine medical care. Chaplains visit patients, and arrange for patients to see their own pastors upon request.
• Physical therapists (PT) and physical therapist assistants work with patients to improve strength, balance, and mobility. Physical therapy helps restore and maximize functional mobility and improve endurance after an injury or illness.    
• Occupational therapists (OT) work with patients to improve functional mobility focusing on activities of daily living. 
• Speech Language Pathologists (SLP) evaluate and treat patients who are at risk or have known swallowing, speech, and language disorders. These disorders can be the result of a stroke, traumatic brain injury, cognitive dysfunction, or any other neuromuscular disorder.
  • When consulted, members of the PT/OT/SLP team will evaluate the patient to create a therapy plan of care and frequency of therapy visits for each discipline.

STAR Program

When any St. Joseph Health team member goes “above and beyond” in your care or service, we encourage you to help us recognize these individuals.

You may fill out a Compliment Card, found at any one of our nurses’ stations, and place it in the Compliment Box at the ICU entrance. You may also leave us a message online.

Concerns or complaints

Providing high quality care is the ultimate goal of the healthcare team at St. Joseph Health. ICU stays can be highly stressful; if there is a concern that arises during the hospital visit, please be sure to first communicate with your nurse and/or physician so that the issue can be addressed as soon as possible. If you need further assistance, please ask to speak with the Team Leader, who can assist in resolving, or escalating if necessary. Our leadership team is always available and will ensure any issues are addressed to the best of our ability and with the patient’s safety and well-being as the main priorities. We sincerely appreciate concerns being brought to our attention and providing us an opportunity to respond.

ICU Delirium

What is ICU delirium?

Delirium refers to severe confusion where the patient cannot think clearly, has difficulty paying attention, does not understand what is going on as they typically would, and  may see or hear things that are not there. This can be frightening. Many ICU patients experience delirium. It is caused by changes in how the brain works. Some of the reasons this happens in the ICU is because of decreased oxygen, illness, chemical change in the brain, medication, infection, severe pain, anesthesia, and alcohol withdrawal.

Signs and symptoms of ICU delirium

• Confusion and/or aggression
• Appearing unusually agitated or quiet
• Using inappropriate words
• Inability to pay attention or follow direction
• Unsure about where they are, unsure about the time of day
• Seeing things that are not there
• Acting differently from usual
• Changes in sleeping habits
• Emotional changes
• Abnormal movements, like tremors or picking at clothes
• Memory problems

Delirium comes on quickly, in hours or days. Signs of delirium can change from one day to the next. Delirium can make memory and thinking problems worse. Delirium usually clears up after a few days or even a week.

Prevention strategies for ICU delirium

• Speaking calmly and using simple words or phrases
• Reminding the patient of the day, date, and time
• Open shades and turn lights on during the day
• Turn lights off and close shades at night
• Talking about family and friends
• Bringing glasses and hearing aids
• Decorating the room with calendars, posters, or family pictures
• Turning on the patient’s with their favorite music or TV shows

If your patient is having signs of delirium, you may be asked to sit with them.

Post-Intensive Care Syndrome (PICS) Dana

What is PICS?

Advances in medicine allows us to treat the sickest patients with success, but often patients who have been treated for a serious illness in the intensive care unit have some symptoms that do not go away after they are home. These symptoms can not be completely avoided.

Signs and symptoms of PICS

Some symptoms affect the body. ICU acquired weakness is muscle weakness developed during an ICU stay. This makes getting back to normal daily activities difficult and frustrating. Some symptoms affect the mind. Brain dysfunction, also known as cognitive dysfunction, is when the person has difficulty remembering, paying attention, solving problems, and/or organizing complex tasks. Some can have other mental health problems. This can include nightmares or unwanted memories, depression, difficulty sleeping, strong feelings or emotions, depression, and anxiety. These can be symptoms of posttraumatic stress disorder.

PICS for Families

After a family has had an ICU stay and the family has been asked to make overwhelming decisions, they also can experience mental health symptoms such as anxiety, depression, and posttraumatic stress disorder. It is very important that the family of an ICU patient takes care of themself. Their needs are just as important as the patient’s needs. It is important to eat well, rest, exercise, call on assistance whether from family and friends or from the hospital to assist with resources such as case management and spiritual care

ICU Diary

A diary of the time the patient spent in the ICU can be valuable in helping the patient understand their critical experience. They may have memory gaps, partial memories, hallucinations, and nightmares from the time that they were sedated and/or intubated in the ICU. A diary written by family, friends, and healthcare staff about what is happening both in the hospital and at home for the patient to read after discharge to fill gaps in memory. This helps them understand what happened in the ICU and while they were away from home. ICU diaries can reduce the risk of developing Post Traumatic Stress Disorder for the patients and families.

Common Medications in the ICU

• For sedation and pain management
  • Dexmedetomidine
  • Fentanyl
  • Propofol
  • Lorazepam
  • Midazolam
  • Morphine
• For heart rhythm and blood pressure
  • Diltiazem
  • Dobutamine
  • Dopamine
  • Epinephrine
  • Esmolol
  • Labetalol
  • Nicardipine
  • Nitroglycerine
  • Norepinephrine
  • Phenylephrine
• For glucose management
  • Insulin
  • Dextrose
• To prevent blood clots
  • Heparin
  • Lovenox