31/03 Notes on High Dependency and Intensive Care Units for Midwives

Overview of High Dependency and Intensive Care Units

• High Dependency Units (HDU) and Intensive Care Units (ICU) are both designed for patients requiring close monitoring and specialized care.

• HDUs focus on obstetric conditions related to pregnancy and childbirth.

• ICUs provide care for a broader range of medical conditions, including surgical and trauma cases.

Key Points from the Videos

• Introduction by Judith: Overview of care in High Dependency Units, emphasizing the importance of understanding high dependency care before entering clinical practice.

• Complex Situations: Midwives must maintain midwifery practices amid interventions in complex care scenarios.

• Importance of Relationships: Building rapport with families and understanding their emotional needs is essential in high-stress medical environments.

Key Concepts of Care in HDU and ICU

• Personalized Care: One-on-one care in HDUs is crucial for patients who are critically unwell.

• Collaboration: Multidisciplinary care teams are essential in managing complex cases.

• Equipment Knowledge: Familiarity with medical equipment (e.g., central venous catheters, ventilators, ECG monitors) is necessary for providing safe care in these settings.

Challenges Faced by Midwives

• Isolation of Patients: Patients in intensive care may feel isolated; offering family presence and opportunities for touch (e.g., skin-to-skin contact) can alleviate this stress.

• Family Dynamics: Midwives must navigate varying family needs and dynamics, providing tailored support based on familial desires for involvement in care.

Emotional Preparedness and Support

• Coping with Loss: Midwives often experience emotional challenges when dealing with patient loss; support systems (both professional and personal) are vital.

• Role of Debriefing: Regular debriefing sessions with colleagues and mental health professionals can assist in managing the emotional toll of intensive care situations.

Practical Skills and Knowledge

• Equipment Management: Midwives should understand how to manage IV lines and other equipment used in HDUs and ICUs.

• Monitoring Vital Signs: Continuous monitoring is crucial; midwives should be able to interpret vital signs and respond appropriately to changes.

• Communication: Effective communication with the care team and families is essential in high-pressure environments.

Reflective Practice

• Self-Assessment: Midwives should continually assess their feelings about patient interactions, especially in situations involving loss or complicated care needs.

• Seeking Guidance: It's important to reach out for guidance when faced with complex emotional situations with families.

• Navigating Confidentiality: Midwives must be cautious about maintaining confidentiality regarding patient information.

Future Considerations for Midwifery Practice

• Stay Updated: Continually educate oneself about changes in HDU and ICU practices.

• Local Resources: Familiarize with local support resources available in the community for families undergoing crises during obstetric care.

• Explore Specialties: Understand the differences between HDUs, ICUs, and critical care units, as well as their respective roles in maternal health.

Introduction

Midwives and students working in High Dependency Units (HDU) are trained to provide specialized care for women, particularly during critical stages of pregnancy and childbirth.

Training and Education

• Overview of Training: Midwives and students undergo comprehensive training that prepares them to manage complex care situations in HDUs. Continuous education is emphasized to keep up with new practices and technologies.

Video Resources

• Midwifery Care for Women in HDU (0:21): This video provides an overview of the specific needs of women in HDU and the essential principles of midwifery care in such settings.

• Care of the Sick Woman (0:30): Focuses on assessing and managing the care of women who are ill, highlighting clinical decision-making and intervention strategies.

• Story (2:18): A personal narrative that illustrates the challenges and experiences of women receiving care in HDUs. This story aims to foster empathy among care providers.

• Working with Women Who Are Unwell (5:54): This video shares insights from clinicians on how to provide emotional and physical support to women in distress.

• The Team Who Work with Sick Women (6:15): Describes the collaborative approach to patient care in HDUs, emphasizing the roles of various team members including midwives, doctors, and support staff.

• Information on Videos in Module 10 (6:27): An introduction to additional resources and educational materials provided in the course module that complements practical learning.

Key Medical Concepts

• Ventilators (28:54): An overview of the function and use of ventilators in supporting women with respiratory distress who are admitted to HDUs.

• Postpartum Haemorrhage (30:15): Discusses the risks and management strategies for postpartum hemorrhage, a critical concern in maternal health.

• Tamponade Technique of Gauze Packing (33:48): Explains this technique as an intervention for managing severe hemorrhage in women, detailing steps and clinical indications.

Specialized Care

• Care for Most Adult Specialties (36:33): Overview of the DCCM or CCU setup, which provides critical care to various adult specialties beyond obstetrics.

• HDU: Specialized Care for Pregnant Women (36:54): Highlights the unique aspects of HDUs as they cater specifically to the medical and emotional needs of pregnant women and those with obstetric complications, differentiating them from other intensive care settings.

Conclusion

Midwives and students play a vital role in providing compassionate and specialized care in HDUs. Their training, experience, and collaborative efforts are crucial in supporting the health and recovery of women under their care, particularly in complex and high-stress situations.