What is a Medical Intensive Care Unit (MICU)?
A MICU is a location in the hospital where critically ill patients receive care. As a medical ICU, we care for patients with a variety of conditions, many of them life-threatening. As experts in managing these conditions, we work together as a team to care for each patient.
How can I learn what is going on with a patient in the MICU?
As a valued team member, we encourage patient and family participation during our daily work rounds. Daily rounds occur between 9am and 12:30pm, where the care team will discuss recent events, the plan for the day, and the patient or loved one’s goal for the day. This is also a time to have your questions answered.
Patients requiring a stay in the ICU for two or more days will meet with the care team to discuss the current diagnosis and prognosis. By providing your preferred contact information, we can contact you directly with any changes to the patient’s condition. You can also contact the Unit directly at (215) 662-9600 to speak with a team member. It is helpful to designate one family member or caregiver to be the contact point. This assists in the accurate and efficient flow of information.
Who is caring for my loved one?
Care teams in the MICU include an attending physician (or team leader), hospitalist, bedside nurse, and critical care pharmacist. These are the team members, at a minimum, who will join daily patient and family-centered care rounds.
Depending on the patient’s needs, additional team members may include physical and occupational therapists, respiratory therapists, social workers and palliative care experts. These team members should introduce themselves and their role. If they don't, we encourage you to introduce yourself and ask our team members to introduce themselves.
What does the difference in color of scrubs mean?
A team member wearing maroon scrubs is a certified nursing assistant. They are here to help the patient’s with personal care, obtain an EKG before the nurse gives you certain medications, draw blood, position the patient to be and restock MICU rooms.
A team member wearing navy blue scrubs is a registered nurse. They are here to help you 24 hours per day. Our team of critical care nurses are exceptional, both in their knowledge of critical care and compassionate when caring for a patient.
A team member wearing black scrubs is a registered respiratory therapist. They are here to help you breathe better by providing you with medications or therapies and in managing the setting of your mechanical ventilator if you or your loved one need the respiratory support provided by the ventilator.
What is palliative care?
Palliative care is specialized medical care that provides an extra layer of support to patients with serious illnesses including patients who are undergoing aggressive treatment. Palliative care is appropriate for patients at any age and at any stage of a serious or chronic illness.
The palliative care team will focus on your loved one’s symptoms while they are critically ill. While tending to their physical needs, they also tend to their emotional and spiritual needs as well as yours as family members. In partnership with our chaplaincy division, these team members serve as vital team members to support our patients and family.
To tend to your loved one’s spiritual needs, we have team members available from the chaplaincy division. We encourage you to let us know if you would like us to engage these team members during your stay.
Is palliative care the same as hospice care?
No. Palliative care is available to all patients and their families at any stage of a serious illness and is often provided for patients as they undergo aggressive and curative treatments. Hospice offers a comprehensive package of services to patients with a prognosis of six months or less and whose goals are focused on comfort.
Despite our best efforts, given the conditions that lead to ICU admission, sometimes our patients are too ill and do not survive. Hospice also provide bereavement services, an important role to support our families and our community through this difficult time.
What can I, as a loved one, do to help?
We recognize and respect the many roles that loved ones take on in the ICU: active presence, protector, facilitator, historian, coach, and voluntary caregiver. We support you in each of these roles, as they serve to help your loved one recover and because we value you as a team member.
Specifically, there are five ways that you can help your loved one.
- We encourage you to share knowledge about your loved one's conditions, as well as their goals and preferences for care, to ensure that we provide the right care for your loved one.
- We encourage you to visit whenever you are able. We encourage you to speak with your loved one, and to bring photos, pictures, art, or other cherished items that will help us know your loved one and to help your loved one stay connected to that which he or she holds dear in this world. We encourage you to share words of encouragement. And we encourage you to join rounds as your schedule permits.
- As pain, anxiety, sadness, fear, and confusion are common during critical illness, your presence alone is comfort to the critically ill. For those receiving life support, we encourage you to participate in your loved one's ICU diary, by entering entries when you visit that share words of encouragement and record the daily events during their stay in the ICU.
- If you are interested, you can ask your loved one's nurse how you can participate in your loved one's care. Given the intensity and frequency of thirst, you may be able to partner with your loved one’s nurse to provide a moist sponge to lessen their thirst, as an example.
- As music has been shown to decrease psychological distress in the critically ill patient, we encourage you to play music that your loved one enjoys.
What is the ICU Diary?
The ICU diary is an account of your (or your loved one’s) experience in the ICU. For patients receiving life support (e.g. mechanical ventilation), sedation use is common. These powerful drugs often leave patients with gaps in their memory as they recover. These gaps can cause symptoms of anxiety, confusion, and post-traumatic stress disorder.
To fill these gaps, and to decrease these psychological symptoms, the diary can be used as a powerful tool during recovery to understand what actually happened, and what did not, during the ICU stay. In addition to sharing factual information from clinical team members, the diary is a chance for staff and loved ones to document words of love and encouragement that can help support and facilitate recovery after critical illness. If you are interested in participating in an ICU diary for yourself or your loved one, please let us know, and we will walk you through the experience.
What is an LTACH?
An LTACH is a long-term acute care hospital. It is not a nursing home. In our MICU, this most likely occurs when a patient remains dependent on the ventilator for breathing. With more time, usually measured in 3-5 weeks, you may be able to breathe on your own again, and continue on your recovery thereafter.
Unfortunately, as many such patients are suffering from chronic critical illness, set-backs are not uncommon, and the majority of patients who are discharged to an LTACH are unable to return home. We encourage you to obtain more information about the outcomes of such patients if LTACH is being discussed as an option for you or your loved one, so that your expectations are both hopeful and optimistic, as well as realistic.
Are there opportunities to give back to the MICU?
There are several opportunities to give back. First, you are welcome to share your experience with others through the peer to peer support groups. Second, you are welcome to volunteer your time at Penn Presbyterian, including potentially serving as a Patient and Family Advisory Council to the Penn Presbyterian MICU. In these roles, you would serve as an adviser to our on-going efforts to provide the highest quality care to our patients. For more specific information, or to better understand your interests, please email: ICURecovery@uphs.upenn.edu.
I want to thank you or a team member within the ICU. How can I do that?
We care deeply about our patients and our community, and value both positive and negative feedback. If you would like to share a testimonial of your experience, express your gratitude, or share words of encouragement with future patients, please send an email to ICURecovery@uphs.upenn.edu.
I see opportunities for improvement. Can I share these with someone?
Yes. Please do. To be the best, we are continually searching for ways to improve our care. Please contact MICU leadership directly to share your ideas or concerns.
Do you conduct research at Penn Presbyterian?
Yes. As one of the leading academic institutions in the world, we at Penn Medicine, and in the Penn Presbyterian Medical ICU, support and conduct research to generate new knowledge as we are committed to providing you with the highest quality of care. If an opportunity exists to be a research participant, you will be provided with the information to make the right decision for you, and will have the opportunity to agree to participate, or decline, based on your preferences and goals.