Critical Care Family Liaison team, University Hospitals Birmingham NHS Foundation Trust
During the coronavirus pandemic, the hospitals within our Trust had to quickly prepare to accept a high number of coronavirus patients. At the height of the pandemic, critical care bed numbers quickly expanded to accommodate hundreds of patients needing intensive care across our 3 sites. Coinciding with this rise in numbers of critically ill patients was a restriction on all visitors to our hospitals. While additional staff were drafted in to help provide the vital one to one care, this left very few staff available to communicate with family members who were not permitted to visit. A group of medical students, with support from ICU consultants and other retired / returning consultants, became the critical care family liaison team and the first point of contact for worried relatives. Each student was responsible for a caseload of 4 - 5 families. They gathered information about each patient's progress and key messages for the following days plans. They called the patient's family daily to update them on their relative's condition. These calls were recorded in writing and discussed at the end of their shift, to ensure that any difficulties were identified, and support offered where needed.
The students were also able to pass messages from family to patients and specific questions to the medical teams. One message for a patient simply said: "Please come home daddy." The students also kept a diary for each patient, detailing their progress, which the patient or family could take home with them if they wished, giving them time to reflect on their time in hospital. Intubated patients, because of the sedation needed to help them to breath, typically have very few memories of their time in hospital, so this offers them an insight into their treatment.
This group of students have had a crash course induction to critical care and will have a unique insight into communication with the families of critically ill patients. One student even said: "The conversations have helped me define the type of doctor I want to be", while another commented: "I am extremely grateful to the relatives, for they have taught me more than any amount of formal education ever could." We are grateful to the teams across our critical care sites. We know that the support that they have provided for families, has come at considerable emotional cost. Sensitive debriefing and mutual support has been put in place for those who have needed it. One thing they were not expected to do was to break the bad news of someone's death. Likewise, if they reviewed the notes and felt that the patient was deteriorating rapidly or was too complex a case, they would discuss it with one of the supervising doctors and, if they agreed, request that the ward speak to the family directly. This didn't fully protect them from all difficult conversations because every day a patient remains on a ventilator in critical care is bad news.
Nominated by: Jess Phillips MP
During the first wave of Coronavirus the work of this team keeping families connected with patients was vital while visits were restricted, it’s a pleasure to see their work recognised.