“People are scared, and they don’t know what to expect,” says Janna Di Pinto, a social worker who sees patients and families in the Tory Trauma Program at Sunnybrook.

Here are five tips for supporting a loved one through an unexpected stay in the critical care unit:

1. Education is key

Patients in the critical care unit often end up there suddenly, leaving families little time to make sense of what’s happening.

“As social workers, part of our role is to provide education on what to expect during a critical care stay. Patients can be doing well one day, and not so well the next, and it’s important for family members to know that such changes in their loved one’s condition are common,” says Di Pinto.

Staff members talk to family members about some of the expected responses and feelings they may have in this crisis event, such as:

• Feeling scattered and unable to think straight
• Processing information poorly
• Decreased short-term memory
• Decreased sense of hunger or thirst

Other helpful educational resources are available online on Sunnybrook’s Navigating the ICU website, which was developed after extensive collaboration between staff and family members.

2. Establish defined roles

In the critical care unit, families can spend a lot of time sitting at the patient’s bedside, but they aren’t sure how they can help.

Family members can contribute to their loved one’s recovery by making a playlist of the patient’s favourite songs to play at the bedside, holding the patient’s hand, bringing in photos and ensuring staff are aware of what is important to the patient.

At Sunnybrook, family members are also encouraged to participate in the care team’s daily rounds at the bedside.

“Staff can teach family members how to participate in their loved one’s care, such as encouraging range of motion exercises or redirecting a patient from pulling tubes and lines,” says Di Pinto.

3. Give yourself permission to take care of yourself

 Di Pinto says it’s important for family members to give themselves permission to take care of their own wellbeing, too.

“We don’t expect them to be at a patient’s bedside 24/7. It’s okay for them to go home, rest and then call the unit as often as they like to check in,” says Di Pinto.

Coordinating a rotating visiting schedule with others can be helpful, because it allows everyone a chance to be at the hospital while also building in time to look after themselves.

“People have many demands to juggle – maybe they live far away from the hospital, or have to return to work, or need to sort out child care. This is a time to establish a new balance and figure out new roles for themselves,” she says.

 4. Find coping strategies that work for you

Some people have a lot of anger after their loved one ends up in critical care, says Di Pinto, particularly if the admission was the result of a trauma (like a car crash) caused by someone else.

“We help family talk about which coping strategies may work best for them. For example, we let people know where the quiet spaces are around the hospital, such as the chapel or going for a walk outside. We let them know it’s okay to go to the gym, spend time with friends or pets, or even just go outside and scream if they need to,” she says.

5. It’s okay to have hope 

Di Pinto says they often talk with family members about the road to recovery, and how it is a process that takes time.

“When your loved one is in critical care, there may be a fine line between being hopeful and being realistic, but it’s okay to have hope that your family member will recover.”

The post 5 tips for getting through a loved one’s stay in the critical care unit appeared first on Your Health Matters.

The field placement is an important component of all health-care degree programs. It is the key context in which theory and classroom teaching can be observed, applied and integrated through practice and the process of skill development. In Social Work, the Council on Social Work Education refers to field placements as the “signature pedagogy” of the profession, underscoring the preeminence of this component of the degree.

The issue of how to generate sufficient numbers of student placements in agencies has long been a concern for both universities and the field alike. On the one hand, there has been increasing pressure on the practice community to supervise more students as degree programs have increased their admission quota. On the other hand, hospital settings in particular have experienced well-documented challenges that have negatively impacted their abilities to offer field placements, especially due to high volumes, acuity and complexity of caseloads, as well as restructuring of hospitals and the loss of clinical positions.

Within this context, the social work service at Sunnybrook has developed an innovative and unique approach to ensuring that each of our staff is fulfilling their education mandate in working in a teaching centre. We have developed and implemented a Social Work Student Education Standard (SSES), adopted in May 2010. This is one standard within the profession’s “Standards of Practice” document, which sets out the minimum standards of professional practice, expectations, and accountability for all social workers at Sunnybrook in regard to student education. The aim is to ensure consistency and equity across all areas of practice, and in so doing, to ensure participation in teaching activities, specifically in the area of offering student placements.

In essence, the SSES clarifies the nature and components of social work field education at Sunnybrook and sets forth the indicators and activities for social workers, in line with the University of Toronto Teaching Centre Guidelines. It has been affirmed that such expectations for education should be made explicit in job descriptions and in the process of new staff hiring, as well as incorporated into performance appraisals of existing staff members. Clearly, a key indicator in the SSES is the one that states: “All staff are expected to offer an MSW practicum a minimum of once every 2 years if it is undertaken in a rotational model, or once every 3 years if it is a full placement”.

This standard is really a formalizing of the activities one expects from a staff member who chooses to work at a tertiary care centre such as Sunnybrook, where our mandate includes being a teaching hospital and a centre of excellence in student education. The assumption is that if you choose to work here, you commit to educating students, and to doing so continuously. However, we recognize that such a standard does not speak to the issue of the quality of the education program, nor the subjective approach undertaken by the staff members in carrying out these activities. Indeed, you simply cannot ‘standardize’ a passion for teaching!

Since implementing the standard in 2010, social work staff participation in education activities at Sunnybrook, including offering student placements, has increased. We are currently in the process of evaluating the impact of this standard through a research grant from the Bertha Rosenstadt Trust Fund at the University of Toronto, to be completed in 2014. We believe the SSES is the first of its kind in Canada, and that it will have further positive impacts in its potential for replication across other health care disciplines.

If you’d like more information about the SSES, or would like a copy, please email illana.perlman(at)sunnybrook.ca.

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