The ICU is one of the places of the hospital where family members live more suffering, especially when the prognosis are poor.

Uncertainty is a feeling standing on the families of admitted patients in critical units, often influenced by variations in the situation of the patients. The absence of information and continuous communication with health professionals (doctors and nurses) makes to present symptoms of anxiety by 69%, increasing until 73% when the prognosis is of imminent death.

Recently several strategies are being proposed to cope with the stress of family members. Such strategies are intended to reduce the psychological burden of the family:


  • Proactive and effective communication 
  • Printed information materials (brochures, information on paper…) 
  • Shared information physician-nurse
  • Follow by nurse
  • Family engangement in the care
  • Psychological assessment
  • Post Intensive Care interventions









It is clear that communication is the key strategy to improve dramatically the psychological burden of members of the families.

As a nurse, I am proud to know that in other countries, some teams have implemented a specialized nurse caring for the family, whose main function is to optimize communication with the family, which includes: making rounds with the care team, answer questions from relatives, the familiarization of the families to the environment of the ICU, the education of families and staff , the emotional support, educate families and prepare them for the discharge of the ICU…

I believe that we must go a step further and that will be a daily feature of the nurse in the ICU.

Currently, ICU nurses are afraid of information / communication with family members. This fear is based on the lack of knowledge about what they should report; in the respect to not invade or overlapping information as given by the physicians, because sometimes, we consider that it is not our function…

We hope that these new changes will arrive soon and we get that nursing will start to take greater weight in the process of information and communication in the ICU.

Carmen Díaz Centeno
ICU nurse at Hospital General Universitario Gregorio Marañón

REFERENCES
1. Curtis JR, Cook DJ, Wall RJ, Angus DC, Bion J, Kacmarek R, et al. Intensive care unit quality improvement: a “how-to” guide for the interdisciplinary team. Crit Care Med. 2006 Jan;34(1):211–8.

2. Plost G, Nelson D. Family care in the intensive care unit: the Golden Rule, evidence, and resources. Crit Care Med. 2007 Feb;35(2):669–70.

3. Davidson JE, Jones C, Bienvenu OJ. Family response to critical illness: postintensive care syndrome-family. Crit Care Med. 2012 Feb;40(2):618–24.

4. Azoulay E, Pochard F. Communication with family members of patients dying in the intensive care unit. Curr Opin Crit Care. 2003 Dec;9(6):545–50.