Coping when your child is admitted to the paediatric intensive care unit (PICU)

This leaflet covers how parents and carers may feel, as well as suggestions for helpful ways of coping.

Having a child on PICU is very stressful.

Life goes on outside of hospital. People still have to work and look after other children. There may also be financial worries.

Looking after yourself means having regular breaks. We encourage you to be with your child while they are in hospital, but it is important to have meals, drinks and to get fresh air and sleep, when you can.

Feelings

Having a child on PICU is stressful and traumatic. This may be because it feels scary, and out of your control. It is normal if you have experiences and feelings during this time.

Some parents or carers tell us that when their child is admitted, they first feel worried or upset, but later start to feel angry or guilty.

When you experience stress or trauma, memories of these events are stored in your brain in pictures, smells, sounds, feelings and thoughts.

What happens when we experience stress or trauma?

When your body experiences stress or trauma, this causes a “fight, flight or freeze” response. Some parents and carers tell us that this feels like a fast heartbeat, quicker breathing and tense muscles.

This is because your brain is preparing your body to fight off the threat or take flight towards safety. Sometimes your body may also freeze. If you experience a lot of stress and trauma over a long period of time, you can feel physically and mentally exhausted.

Coping strategies

Here are some techniques that some parents and carers have found helpful to cope with these feelings. These are outlined in more detail later in this leaflet:

• Grounding.
• Square breathing.
• Keeping a normal routine.
• Seeking support from others.
• Muscle relaxation.
• Tips to improve sleep.
• Tips to improve concentration.

Grounding

Grounding brings your mind and body into the present moment by paying attention to what is going on around you. It uses your five senses: sight, touch, hearing, smell and taste. Grounding can help you to feel calm when it feels like you have lost control.

1. Look for five things you can see. Say their names out loud. Which one is nearest to you?
2. Find four things you can touch. Touch them. How do they feel under your fingertips?
3. Listen for three things you can hear. Can you identify what is making the noise?
4. Sniff two things that you can smell. Do the smells remind you of anything?
5. Taste one thing in your mouth. What did you last eat or drink?

Square breathing

Square breathing helps to slow down and calm your breathing. It helps to distract your mind and relieve the stress in your body.

To start:

1. Breathe in slowly through your nose whilst counting to four, and feel the air entering your lungs.
2. Hold your breath for four seconds.
3. Exhale slowly through your mouth for four seconds.
4. Repeat these steps until your breathing becomes slower and you feel calmer.

Keeping a normal routine

Some parents and carers tell us it can be helpful to develop a consistent daily routine whilst in hospital when possible. For example, coming to the ward each morning at the same time and planning regular breaks, mealtimes and bedtimes. They say that this can help with feelings of tiredness and stress.

Planning daily routines can be difficult to do, so it might be useful to speak to a member of staff who is looking after your child to see if they can help you to plan.

Support from others

Parents and carers tell us that having support from friends and family is very important when your child is in PICU. This may be difficult for you if you are a long way from home but phone calls, texts, and video calls may help you feel connected.

Communicating with family and friends about your child’s condition can be stressful. Some families find it helpful to ask one friend or family member to be the link person for them who contacts everyone and passes on information about how your child is doing.

If you have questions about your child’s care, please speak to a member of staff.

Within the hospital there are chaplains, social workers, and psychologists who may be able to support you with specific issues.

Chaplains can support you with religious, spiritual and pastoral care.

Social workers can support you with financial or practical issues like housing or family difficulties.

Psychologists can support you or your child with coping and your mental wellbeing.

Muscle relaxation

When your body is dealing with stress, your muscles can feel achy and painful. Muscle relaxation may be helpful in reducing this and making you more comfortable.

This is one method that parents and carers tell us that they find useful.

Try this relaxation sequence:

Tips to improve sleep

Parents or carers tell us that they can find it difficult to sleep when their child is in hospital. Having better sleep can help you feel more able to cope and support your child.