The Intensive Care Unit (ICU) Visitors' Guide

This information describes what to expect while your loved one is in the Intensive Care Unit (ICU) at Memorial Sloan Kettering (MSK).

The ICU can be overwhelming and stressful. It can be hard to understand what’s going on. It’s normal to have questions, and the ICU team is here to help you. Please let us know when you have questions or if there’s anything we can do to support you.

About the ICU

The ICU is located at:

1275 York Avenue (between East 67^th and East 68^th Streets)
New York, NY 10065
M elevator to the 11^th floor

The ICU admissions process

The ICU admissions process can take up to 2 hours, depending on your loved one’s condition. Please have patience during this time. We do everything we can to make your loved one as comfortable as possible and to make sure they’re safe and stable.

Visiting your loved one in the ICU

ICU visiting hours are from 11 a.m. to 6 p.m.

Gowns, gloves, and masks must be worn by all visitors while in the patient’s room.

Only 2 visitors are allowed at the bedside at a time. 

It’s important for patients to have visits from family and loved ones, but visits can sometimes be tiring for patients. Please keep track of your time with your loved one.

What to expect in the ICU

Each patient in the ICU has their own room. Most people will be attached to medical devices with cables and tubing. Each medical device has alarms. They alert the nurses to changes in the patient’s health condition or as a response to their movements. The nurses know what these alarms mean. They will respond to them as needed.

While you’re in your loved one’s room, please follow these guidelines:

• Let your loved one know you’re there with them and that you support them. You can do this by:
  • Touching and holding their hands.
  • Talking to your loved one and reminding them what day and time it is.
  • Bringing in pictures or newspapers.
• Space in the room is limited. Please take home any belongings your loved one does not need.

About the ICU team

The ICU team includes many healthcare providers who are experts in intensive care (also called critical care). These ICU team members can include:

• The ICU attending. This doctor makes decisions about your loved one’s care. They’re trained in critical care medicine. Twice a day (in the morning and evening), the ICU Attending will be “leading rounds.” This is when all the members of the ICU care team visit each ICU patient and discuss their progress. 
• ICU fellows. These are doctors trained in internal (general) medicine or another specialty. They’re now getting more training in critical care.
• Residents are doctors who have completed their medical school training.
• Nurse practitioners (NPs) and physician assistants (PAs) have training and experience in critical care. They’re also known as advanced practice providers (APPs).
• ICU nurses are registered nurses (RNs) with special training in critical care nursing. They give patients bedside care. As much as possible, the same nurse will care for your loved one. That way they get to know your loved one and their needs. Our ICU nurses work 3 shifts: 7 a.m. to 7:30 p.m., noon to 12:30 a.m., or 7 p.m. to 7:30 a.m.
• Social workers help you manage emotional and practical issues related to when your loved one is very sick. To talk with a social worker, ask your loved one’s healthcare provider for a referral or call 212-639-7020.
• Respiratory therapists have special training in caring for people with breathing problems.
• Clinical dietitian nutritionists make sure patients get proper nutrition when it’s appropriate. They’ll help your loved one make food choices when they can eat. If your loved one can’t eat, they will plan the nutrition they get from a feeding tube placed in their stomach.
• Physical therapists (PTs) help people get their physical strength back during and after their illness.
• Occupational therapists (OTs) help people care for themselves as much as possible. They also help them work on the skills they need for everyday activities.
• Patient care technicians (PCTs) and nursing assistants (NAs) help nurses with bedside care.
• Unit assistants help the ICU work more smoothly. They answer phone calls, respond to patient and visitor questions, and coordinate services.
• Medical students may work with other healthcare providers and observe care during the day.
• During each shift, the ICU is managed by a Charge nurse and the ICU nurse leader. They manage patient care and patient transfers within the ICU. They work closely with all members of the ICU team and talk with patients and family members as needed. Family members and patients can also schedule time to talk with the charge nurse or nurse leader if they have questions or concerns.
• The ICU clinical nurse specialist works with the ICU team to oversee the nursing practice. 

Preventing Infection

Hand hygiene

Germs are often found on your hands or on things you touch. When germs get on or in the body, they can cause an infection. All patients are at risk for infection while they’re in the hospital.

Hand hygiene is the best way to prevent the spread of germs and infections. It only takes 20 seconds of washing your hands or using an alcohol-based hand sanitizer (such as Purell^®) to kill these germs.

• If you’re washing your hands with soap and water, wet your hands and apply soap. Rub your hands together thoroughly for 20 seconds, then rinse. Dry your hands with a paper towel and use that same paper towel to turn off the faucet.
• If you’re using an alcohol-based hand sanitizer, be sure to cover every part of your hands with it. Rub them together until they’re dry.
• Read the resource Hand Hygiene and Preventing Infection for more information.

Infection control safety measures

All patients in the ICU are placed on ICU standard isolation precautions (safety measures). These precautions help protect your loved one. There’s a sign posted on the door of your loved one’s room or on the electronic display outside their room. It lets you know what type of isolation they will need.

• All staff and visitors who enter the patient’s room also must follow safety measures. They must clean their hands with an alcohol-based hand sanitizer or soap and water. They also must wear a gown and gloves, which are kept outside the patient’s room.
• Each time you enter the room, you must put on a new clean gown and gloves.
• You must take off the gown and gloves before you leave your loved one’s room. Throw them out in the garbage bin inside the room. As soon as you leave the room, clean your hands with an alcohol-based hand sanitizer or soap and water.
• Anyone who has a cold or any signs of illness should not visit the ICU.
• Use the hooks outside the room to hang your coats and personal belongings.
• Do not bring fresh cut, dried, or live flowers or plants into the ICU. They can carry germs that can cause infections in very sick patients.
• To prevent exposing patients to contagious viruses and infections, ICU visitors shouldn’t bring infants and young children who aren’t able to follow the infection control precautions.

Rehabilitation therapy and early mobility

ICU patients are assessed by physical and occupational therapists to see how they can improve their strength and conditioning. When you visit, try to help your loved one feel awake and alert during the day. This way, they can have physical and occupational therapy sessions to help improve their overall health and well-being.

All patients attached to mechanical ventilators (machines to help them breathe) are assessed for our Early Mobility Program. In this program, the ICU nurse and a team of therapists (physical, occupational, and respiratory therapists) help patients increase the amount of activity they can do each day. This may include doing activities in bed, sitting in a chair, or walking.

Delirium

Patients in the ICU may sometimes develop delirium. Delirium is a sudden change in the way a person thinks and acts. Many things can cause delirium. Talk with your loved one’s care team about what may be causing it.

The ICU staff members are trained to help your loved one with delirium. They know how to manage and treat it. You can help prevent delirium or help your loved one if they get delirium by doing the following things:

• Talk with your loved one about where they are, the date, and the time.
• Encourage your loved one to get help from a physical and occupational therapist.
• If your loved one uses glasses or dentures, bring them to the hospital so they can use them.
• Show your loved one pictures of your family or familiar items and talk with them about it.
• Limit TV and provide quiet time. Let your loved one take naps during the day and sleep at night.

For more information about delirium and how you can help, read the resource Caring for Someone With Delirium. You can also talk with a member of your loved one’s care team.

Patient updates

Different members of the ICU team can give you a daily progress report. More formal family meetings can also be planned with members of the ICU team, if needed. The ICU team works closely with your loved one’s primary doctor (oncologist or surgeon) to coordinate their care. They also will review your loved one’s case with other specialists as needed.

MSK follows the national standards for security and confidentiality of health information. These are the Health Insurance Portability and Accountability Act (HIPAA) standards. You can read about the MSK privacy policy by going to www.mskcc.org/cancer-care/privacy.

Calling for updates

Choose 1 contact person to get updates and information about your loved one. This person should also give the nurse their contact information. That way the nurse can call if there are any changes in your loved one’s condition. The contact person can call the ICU at 212-639-7555 for updates. The contact person should share updates with the rest of the family or friends as your loved one would want.

If possible, avoid calling the ICU between 7 a.m. and 9 a.m. and between 7 p.m. and 9 p.m. During these times, the nurses are getting ready to change shifts. They may not be able to take your call.

Caring for yourself

Having a loved one in the ICU can be very stressful. It’s important to take care of yourself. Your loved one needs you to be strong and well. The following suggestions may help.

• Get rest. Leave the hospital at night after visiting hours and try to sleep at home.
• Eat regularly and drink plenty of liquids so you can stay healthy and hydrated.
• Keep in contact with your family and friends.

MSK support services

Patient Representatives
212-639-7202
The Patient Representatives (patient reps) can be reached at 212-639-7202. They’re here to make sure your rights are respected, and your concerns are addressed. The patient reps can speak on your behalf and represent your interests. They can answer your questions about hospital policies and procedures.

Spiritual Care Department
212-639-5982
Our chaplains (spiritual counselors) are available to listen, help support family members, and pray. they can contact community clergy or faith groups, or just be a comforting companion and a spiritual presence. Anyone can ask for spiritual support. You do not need to be in any formal religion.

The Mary French Rockefeller All Faith Chapel is in room M106 near the main lobby of the hospital. The address is 1275 York Avenue (between East 67^th and East 68^th streets). It’s open 24 hours a day.

Chaplains can be reached during the day at 212-639-5982. If you have an emergency, please call the hospital operator at 212-639-2000. Ask for the chaplain on call. You can also ask the nurse to arrange for a chaplain to visit.

Social Work

212-639-7020

Social workers help patients, families, and friends deal with common issues for people who have cancer. They provide individual counseling and support groups throughout your treatment. They can help you communicate with children and other family members.

Our social workers can also help refer you to community agencies and programs. They also have information about financial resources, if you’re having trouble paying your bills.

Social workers are available. To speak with a social worker, ask your doctor or nurse or call the number above.

Supportive Care Service
Our Supportive Care Service can help with pain and improving the quality of life for our patients. Supportive care is also called palliative care. It includes any treatment given to relieve the symptoms caused by cancer. You can get supportive care at any point during treatment.

Our doctors and nurses can help you manage physical symptoms, such as pain, shortness of breath, and nausea. They also can help with emotional issues, such as sadness, depression, and anxiety.

We work with your primary care team to offer an extra layer of support. If you feel you or your loved one can be helped by the Supportive Care Service, talk with your doctor or nurse.

For a full list of support services at MSK, read MSK Support Services.