Critical Care Department

Critical Care patients often have a complex range of conditions and problems that need teams of specialists to work together to help them. This is known as working in ‘multi-disciplinary’ teams. The medical team includes consultants, experienced doctors and junior and trainee doctors; qualified doctors who are learning how to work in Critical Care. All nurses and doctors have their name and title on their badge or scrubs – please remind them to introduce themselves if they forget!

Critical Care consultants

Advanced Nurse Practitioners

Advanced Nurse Practitioners are senior nurses with extensive training and experience looking after young patients in Critical Care. ANPs work with the medical teams to give patients the best possible care and are a valuable link between doctors and nurses in the unit. There are six ANPs in Critical Care:

Nurses

Laura Reilly is the Clinical Nurse Manager for Critical Care, leading a team of Senior Charge Nurses, Deputy Charge Nurses, staff nurses and practitioners working in the unit on a combination of daytime and night shifts. Each child and family will be given a named nursing point of contact for their time in Critical Care.

Other staff

To deliver the best care to very unwell children, many other staff members from different teams will be involved in the treatment of patients in Critical Care, including dieticians, physiotherapists and pharmacists. Other specialists are also involved in diagnosing conditions and deciding on the best treatment, for example, colleagues from Radiology (carrying out scans and x-rays), Immunology and Infectious Diseases. The treatment plan for each patient will be different and the team involved in each child’s care will always be happy to answer any question from parents and carers.

Day shift nurses work from 8am – 8pm. Night shift nurses work from 8pm – 8am. The nursing shift handovers take place between 7.30-8.15 each morning and evening. During nursing handovers, all visitors will be asked to leave their child’s bedside. This is to protect the confidentiality of both your child and our other patients and allows the nursing teams to carry out a thorough handover of information so that they are delivering the best possible care at all times. There is a Family Sitting Room in Critical Care, and another on Level 3, which is available for families to visit at any time. Handover time can also be a good opportunity to take a break, have something to eat or drink or get some fresh air.

Ward rounds

Ward rounds take place every morning, between 9am-11am. Parents & carers can be present during the medical team ward rounds if they wish. There will be an opportunity to hear an update on your child and ask some questions to the team of specialists looking after them. Please also respect the privacy of other children and families around the ward, should you hear information relating to other patients during ward rounds. Regular medical updates will always be given to families, either at the bedside or in one of our private meeting rooms and we will be happy to explain anything that you are unsure of, or terminology you don’t understand.

Medical Equipment and Environment

The unit has a lot of equipment and machines that can seem daunting at first. We will do our best to answer all of your questions and can explain what each piece of equipment does. We understand that it can be noisy and busy, with lots of different staff coming to see patients at different times. As you continue to visit, we hope that you become less aware of the equipment and feel more at ease. We have a mix of bays (each with 4 beds) and individual rooms in Critical Care. Our Neonatal Unit has space for 4 cots for babies, as well as a ‘rooming-in’ bedroom for babies before going home.

Accommodation

Critical Care does not have pull-down beds for parents to stay overnight next to their child, due to the amount of equipment in the unit and the space needed around each bed. There are two overnight rooms in the unit for families of the most unwell children. Accommodation can be provided in Ronald McDonald House (on Level 3) wherever possible, with en-suite bedrooms, kitchens for cooking and preparing meals as well as sitting rooms and a playroom for siblings. Staff on the ward can check whether rooms are available.

Taking a break

Your child is being well looked after by the nurses and doctors, and while we encourage you to be with your child and help care for them, it is very important you look after yourself too by taking regular breaks. Staff will let you know where you can go for a rest, get food and drink or some fresh air in one of our outdoor spaces. There is a Family Sitting Room on Level 3 of the hospital, with facilities to heat food or make a hot drink, as well as comfortable seating to be able to rest. Please do not feel bad about leaving your child. You can best help them if you are well and rested yourself. Your child’s nurses will call you if your child needs you at any point.

Family Support

Having a child in the hospital can be a worrying time, and support for the whole family is an important part of Critical Care. From financial help or benefits advice, support with travel and transport costs, accommodation for parents, advocacy or a listening ear away from the busy ward, our support services are here to help. Please ask a member of your child’s nursing team about the types of Family Support available, including help from our charity partners or for more information visit our parents and carers page.

High-Dependency & Outreach

High-dependency (HDU) and Outreach services are combined to give coordinated patient care at different stages of a young patient’s illness and recovery. The HDU team works with other specialists within Critical Care, with aims including:

• Shared care, collaborating with teams from Respiratory, GI, Neurology and Haematology-Oncology.
• Better arrangements for ward rounds, communication and handover between teams.
• Learning opportunities for all levels of staff.
• Improved communication with families.

Outreach services include:

• Reviewing children highlighted by their care teams as being unwell or needing close monitoring in case of a change in their condition.
• Reviewing patients recently discharged from Critical Care.
• Reviewing patients receiving HDU level care in other wards.
• Referrals from other wards or the Emergency Department, perhaps needing to be admitted to Critical Care, or with complex medical problems (e.g. after surgery).
• Planning and coordinating care for complex patients requiring frequent hospital visits and admissions to Critical Care.

Complex Spinal Surgery

The Spinal Surgery team at the RHCYP in Edinburgh treats patients from all over Scotland needing surgery to correct spinal problems. Paediatric Intensive Care (PICU) works closely with the Spinal Surgery team to look after these children after their operations.

Palliative Care

Not every child will make a full recovery and decisions are sometimes needed about how best to continue to give them the care that they need. The RHCYP has a specialist Palliative Care team to work with families and help them understand the full range of treatment and care options based on their child’s circumstances. The team can bring colleagues together to help put support in place, always involving the family in decisions and giving choices about treatment at home, or at a hospice if the family so wishes. The Palliative Care team looks at the whole family’s needs and can help to give each patient the best quality of life during the rest of their treatment for more information visit the page about palliative care.

Requests for Observerships and other placements

Information for medical students and trainee doctors interested in observerships, electives and other clinical attachments in our Paediatric Critical Care Unit is available online in the medical electives section of the University of Edinburgh website, with eligibility criteria and contact details.

Links can be found below to websites for families and health professionals to understand more about levels of care.

General Medical Council Opens in new window

Royal College of Paediatrics and Child Health Opens in new window

PaediatricFOAM Opens in new window

Knowledge Network Opens in new window

The University of Edinburgh Opens in new window

Paediatric Intensive Care Medicine Opens in new window

Specialist Transport and Paediatric Retrieval Service Opens in new window

OPENPediatrics Opens in new window