Intensive care is able to provide advanced therapies, monitoring and specialist nursing and medical care to help in your child's recovery.  At the RCH, the Paediatric Intensive Care Unit is called Rosella Ward.

It is understandable that many parents may feel worried or concerned when their child moves from the Paediatric Intensive Care Unit (PICU) to a ward. During your child's stay in PICU, you may become familiar with the staff, and become used to the high levels of monitoring and care provided in the PICU environment. 

When your child is ready for transfer from PICU, it means they are moving to a ward because their condition has improved and they no longer need specialist PICU therapies. This is a positive step forward in your child's recovery.

A PICU outreach nurse will visit your child and help you before, during and after your child's move to another ward. PICU outreach nurses are experienced PICU nurses who will ensure that you, your child and the staff on your child's new ward are fully informed and up to date with your child's progress.

PICU has an outreach team, which includes a PICU nurse and doctor. Once your child has been transferred from PICU, your child will have follow up visits from the intensive care staff to ensure their condition continues to improve.

Things that are different on the wards

• Monitoring:  Monitors on the wards are different to those in PICU. Usually your child won't need continuous monitoring because they are getting better. The ward nurses will still take regular observations.
• Doctors:  A team of doctors will manage your child's care on the ward. The team includes a medical or surgical consultant, who is the head of the team, and other doctors with a range of experience responsible for the day to day care of your child. The medical team will visit your child daily and coordinate all the required care as they monitor your child's progress. Medical or surgical registrars are available 24 hours a day within the hospital to ensure ongoing review of your child.
• Nurses:  Nurses on the wards care for up to four children at the same time. They cannot be at your child's bedside at all times and they will need to leave the room. Sometimes they also need to leave the ward to take other children for tests. If they are off the ward there is always another nurse available for anything urgent.
• Environment:  The ward may be noisier than PICU. There may be more visitors, televisions and the children on the ward may not be as sick. There is a kitchen on the ward with supplies for breakfast. Lunch arrives from 11.30am and dinner from 5.00pm. Usually, you can sleep by your child's bed.

The role of the PICU outreach nurse

The PICU outreach nurse usually meets with you before your child leaves PICU. They will collect information about your child's stay in PICU from the bedside nurse, medical charts and through discussion with you. The PICU outreach nurse can tell you which ward your child will likely be transferred to (but this may change), and what to expect in the new ward environment.

You can ask any questions you may have, and raise any concerns about your child's move with the PICU outreach nurse.

On the day of transfer to the new ward, the PICU outreach nurse will maintain contact with you and your child's bedside nurse to keep you informed of any progress or changes. Because the hospital is a busy place and there is always demand for beds in wards, it is unlikely we will be able tell you exactly what time your child will move.

Once your child is on the ward, the PICU outreach nurse will make visits. The outreach nurse will assess your child, review their charts and check that ward nurses have all the information they need to care for your child. Ask the outreach nurse any questions you have. If you miss the outreach nurse's visit, you can ask to have them paged. If you are very worried about your child, you can activate the hospital MET (Medical Emergency Team) system. 

Key points to remember

• The move from PICU to the ward can be a stressful time for children and their families.
• There are significant differences between PICU and the wards, including the level of monitoring and the number of nurses and doctors on the ward.
• Your child is moving to the ward because they have improved - the move is a positive step forward in your child's recovery.
• The PICU outreach nurse will visit you and your child to support you during this transition phase. Their role is to make the change from PICU to the ward as smooth as possible, and to help answer your questions.

Contact:

• PICU outreach nurse
  8.00am-6.00pm, 7 days a week. 
  Telephone: RCH switchboard on (03) 9345 5522 and ask to have the PICU outreach nurse paged.  
• PICU outreach registrar
  24 hours a day, 7 days a week. 
  Telephone: RCH switchboard on (03) 9345 5522 and ask to have the PICU outreach nurse paged.  
  
• Ward Nurse Unit Manager
  Also called the NUM - 9.00am-5.00pm, Monday – Friday. 
  
  

Developed by ICU Transition Nurses at The Royal Children's Hospital, Melbourne. We acknowledge the input of RCH consumers and carers.

Reviewed August 2020.

Kids Health Info is supported by The Royal Children’s Hospital Foundation. To donate, visit www.rchfoundation.org.au.