This information is for patients who have been admitted to the Intensive Care Unit (ICU) at HMC. This webpage also provides useful information for their loved ones, as well as practical information about the ICU.
About the ICU
The ICU is for patients who need intensive care, special monitoring of their health, or life support. We have an ICU location at HMC Antoniushove and one at HMC Westeinde in The Hague. Patients are admitted to the ICU after surgery, in case of severe illness, or after an accident. The intensivist supervises the medical care you receive in the ICU. This is a doctor who is specialised and experienced in the area of intensive care. Intensivists are on duty at our hospital sites 24/7.
Junior doctors assist the intensivist. The intensivist confers with various medical specialists on a daily basis, and frequently confers with supporting medical specialists, such as the pharmacist, physiotherapist, dietitian, radiologist and microbiologist. This takes place in the multidisciplinary meetings. Specialised nurses and trainee nurses will nurse you. The nurses are the first point of contact for patients and their loved ones.
Each patient admitted to the ICU will have a maximum of two contact persons. These contact persons of the patient will be the contact persons for the doctors and nurses. To safeguard privacy, our medical information about the patient will only be provided to the two contact persons.
The contact persons are of course free to pass on this information to family members or friends.
If the contact persons are not fluent in Dutch, we can use an interpreter, who will interpret over the phone during meetings between the doctor/nurse and the contact persons. This way, the contact persons are provided with all medical information about the patient.
If the patient remains in the ICU for more than one week, we will have a meeting with the patient’s two contact persons at least once a week.
If possible, the patient will make any decisions that need to be made about the patient’s medical care. If the patient is unable to make decisions, only the patient’s (legal) representative is allowed to make decisions about the patient’s medical care. This representative is often a patient’s contact person, but another person can also act as the patient’s representative.
Under Dutch law, an order of priority applies that determines who acts as the patient’s representative. If the patient has been appointed with a guardian or mentor by the court, they will be the patient’s representative. If no guardian or mentor has been appointed, but the patient has designated a representative under a power of attorney, this person will be the patient’s representative. If the patient has not designated a representative under a power of attorney, the patient’s spouse or partner will be the patient’s representative. If the patient has no spouse or partner, or the spouse or partner is unable to act as the patient’s representative, then a parent, child, sibling, grandparent or grandchild of the patient can act as the patient’s representative.
Permission for medical care
Nearly all medical care in the ICU is standard intensive care. This medical care is essential to optimally monitor the health of our patients and to give them the best possible treatment. When you are admitted to the ICU, we will assume that you (or your representative) will give permission for this standard intensive care. Standard intensive care can involve the following procedures:
- inserting canullas and catheters into veins and arteries
- administering medication, such as antibiotics and medication that increases blood pressure
- inserting a breathing tube and mechanical breathing support
- inserting a tube into the stomach or small intestine for tube feeding
- inserting a urine catheter
- suctioning the airways
- administering blood products, such as red blood cells and plasma
- administering contrast medium during an examination
- bronchoscopy to suction mucus from deep inside the lungs (using a tube with a camera attached)
- collecting a brain fluid sample or draining brain fluid
- inserting a drain in the chest cavity or abdominal cavity
- EGD and colonoscopy (examination of stomach and large intestine using a flexible tube with a camera attached)
- renal replacement therapy (a form of kidney dialysis by using a special machine)
We will obviously only administer the medical care that you need. If your representative has any questions about your medical care, the representative can always discuss these with us. If more invasive or less commonly performed surgery or treatment is required, we will discuss this beforehand to ask for permission.
Monitoring equipment around an IC bed
When you are admitted to the ICU, we will connect you to monitoring equipment to continuously monitor your vital signs. This includes, for example, a device that measures your heart rate, blood pressure and temperature, which are displayed on a monitor. There is also equipment that can replace bodily functions if they fail, such as a ventilator for breathing support and a machine for renal replacement therapy. This equipment regularly gives off alarms. The nurses keep an eye on the vital sign readings and alarms from their central location (behind the desk), and know exactly that they need to do when an alarm goes off.
Some rooms in the ICU have video surveillance. This is indicated by the ‘camerabewaking’ (video surveillance) sticker on the door. We use this video surveillance only when this is necessary for the patient’s health and/or safety. We do not store the video surveillance footage. While all monitoring devices in the ICU supplement the observations of the nurses, they certainly do not replace them.
Measures against multi-drug resistant organisms (such as MRSA)
Every patient that stays in the ICU for longer than one night is examined for the presence of multi-drug resistant organisms, which are immune to many common antibiotics. To prevent any spread of such bacteria as best as possible, we nurse each patient in the ICU in ’contact isolation’. To this end, our doctors and nurses wear an overcoat and gloves when giving medical care. If a patient is found to be infected with multi-drug resistant bacteria, we will immediately take extra measures to prevent any spread. For example, by relocating the patient to a separate isolation room. This room is separated from the rest of the ICU by an anteroom, which acts as a hygiene barrier.
When visitors to the ICU are required to wear personal protective gear, such as gloves or an overcoat, the nurse will explain this to them. You can find more information about the measures we take against the spread of multi-drug resistant organisms on our website (only in Dutch). We also have paper copies of this information available.
Patients in the ICU are sometimes very confused or agitated due to their illness. This can lead to incidents, such as patients falling out of their bed or chair. Or a patient may pull loose a cannula, drain tube, breathing tube or catheter. A confused or agitated patient may also step out of bed even though this is medically irresponsible.
Therefore, in exceptional cases, we may place patients in restraints to prevent that they harm themselves. For example, we may place straps so that a patient cannot move their arms and/or legs. We will then check daily if these patient restraints are still necessary. We will remove the restraints as soon as this is medically responsible.
The intensivist and the other doctors treating you will together determine how long you need to stay in the ICU. If you no longer need to stay in the ICU, you will be transferred to a nursing ward. In some cases, patients need to be urgently transferred to another ICU or another type of ward at Haaglanden Medical Centre. Or even to an ICU at another hospital. The latter may be necessary in case of a shortage of ICU beds at HMC, or if specialist treatment is needed that can be better provided at another hospital. In such cases, we will inform you and your contact persons about the transfer. If we transfer you out of our ICU, we will also inform your GP, to ensure your GP is aware of your medical condition.
If you are transferred to a nursing ward, the ICU nurse may see you there to give advice and support. This is standard procedure if you were on breathing support for more than 48 hours. In addition, nurses and doctors at the nursing ward can always contact the ICU to discuss matters.
Visiting the ICU
When patients are being admitted
When patients are admitted to the ICU, it can sometimes take more than an hour before a loved one can visit them. We need this time for things like connecting the patient to medical equipment. In addition, doctors will see the patient. Doctors and nurses will confer with each other and start the necessary treatment. When you accompany a patient to the ICU as a loved one, you can wait in the family room while the patient is being admitted to the ICU. The nurse will pick you up to see the patient as soon as this is possible. When you see the patient, medical care and treatment will continue. Therefore, you may have to wait, or we may ask you to leave the room for a while. We ask for your understanding in such situations.
Patients in the ICU may have no more than two visitors during visiting hours. When the situation requires it, we can make alternative visiting arrangements with you. In addition, different visiting rules may apply during a pandemic (e.g. coronavirus pandemic).
You need to disinfect your hands each time you visit the ICU.
You will find disinfectant dispensers at various places in the ICU, such as on the walls. If you have a flu or stomach flu, it is advisable to postpone your hospital visit.
As ICU patients have weaker immunity, they are more vulnerable to infections.
Children are also allowed to visit ICU patients, if they have been vaccinated in line with the Dutch national immunisation schedule. If want to bring along small children, please inform the ICU nurse beforehand. This will enable the nurse to optimally supervise the visit.
We have information tailored to children available in the ICU.
To make the patient’s stay in the ICU as comfortable as possible, you can bring the following items:
- shaving items
- body lotion
- other toiletries
- slippers or flip-flops for when the patient gets out of bed
Due to hygiene restrictions, visitors may not bring flowers, plants or fruit.
Good alternatives are cards, drawings, photos, cuddly toys and a tablet or other device with earplugs to play the patient’s favourite music. If you want to bring food or drinks, please beware that specific rules apply. The nurse can explain these to you.
You are welcome to visit the ICU at HMC Westeinde or HMC Antoniushove during the following visiting hours:
- from 13.00 to 14.00 hours
- from 18.30 to 19.30 hours
No more the two visitors are allowed during visiting hours. In certain situations, such as during an epidemic or pandemic, different visiting hours will apply. We will inform you about this. Up-to-date information about visiting hours is available on our website: www.haaglandenmc.nl/english/about-hmc/visiting-hours.
Where is the ICU located?
The ICU is on the first floor, near the blue elevator. Turn right after you go through the sliding doors, and report at the reception desk. There is one family room, near the sliding doors.
The ICU is on the third floor. To go to the ICU, take the red elevator. The reception desk is on the right, halfway through the corridor. There are two family rooms. If both family rooms are occupied, you can take a seat in the waiting room near the elevator. Here you will also find a coffee machine and the toilets.
Hosts and hostesses
Hosts and hostesses are present in the ICU to welcome visitors. They will offer you something to drink and escort you to the patient or to the family room. The hosts and hostesses have no knowledge of the patient’s medical history. This is not allowed due to privacy regulations. If you have medical questions, you can ask the nurse.
The hosts and hostesses are there to support you. You can share your experiences with them.
We offer patients and loved ones the option to stay in touch with each other through video calls. With a video call, you can see the patient without visiting. Patients can do video calls on their own phone or tablet. The ICU can also provide the patient with a tablet for video calls. If the patient is unable to communicate independently, the ICU nurse can assist the patient with this. Please ask the nurse about the options for video calling. We will ensure that you have privacy during video calls.
You can wait in a family room while the patient is being admitted to the ICU. We also use the family rooms for conversations between loved ones and doctors. In exceptional situations, we may allow loved ones to stay in the family room overnight. You can ask the nurse whether this can be arranged.
If many family members and/or friends want to be in the family room due to exceptional circumstances, please discuss this with the nurse and/or doctor.
When your loved one is admitted to the ICU, you may feel helpless. You may feel there is nothing you can do to support your loved one. However, there are definitely things you can still do that are very valuable. To help you with this, we have a family participation card. This is a card with suggestions for things you can do to make the stay in the ICU as comfortable as possible for your loved one. For example, by rubbing your loved one with body lotion or helping your loved one eat and drink. Please ask the nurse about the family participation options.
Music in the ICU
Research has shown that music can help soothe the pain and fear of ICU patients. Thanks to music, they need less sleeping medication, anaesthetics, anxiety and pain medication. Musicians specialised in music therapy occasionally visit the ICU. We will announce such visits and you can then let us know what music the patient or loved ones would like to hear. The musicians are affiliated with MuzIC. For more information (only available in Dutch), go to: www.muz-ic.nl.
For your safety, the public areas in the ICU have video surveillance. This surveillance meets all the applicable legal requirements and standards.
At the ICU, we have a number of senior nurses. Each shift, one of the senior nurses acts as the lead nurse.
The lead nurse is well aware of the patient’s medical condition.
The contact persons can call the lead nurse at any time of the day or night. The lead nurse can give information about the patient’s condition. However, please do not call during the change of nursing shifts. Nursing shift changes occur at the following times:
- from 07.30 to 08.00 hours
- from 15.00 to 15.30 hours
- from 23.00 to 23.30 hours
At HMC, we carry out scientific research in our ICU to increase knowledge about various diseases and their treatment. Therefore, a doctor or a research nurse may ask patients to take part in medical scientific research. If you as a patient are unable to reply to such a request, the doctor will pose this question to your (legal) representative. General information on participating in medical scientific research is available on the website of the Dutch government (information only available in Dutch): www.rijksoverheid.nl/onderwerpen/medisch-wetenschappelijk-onderzoek.
Follow-up support for patient, partner and family
Being admitted to the ICU has a big impact and is often upsetting, not only for patients, but also for their partner and family members.
During your stay in the ICU, you may want to talk with someone about your feelings. You can talk with the members of the medical team, but we can also make an appointment for you with a spiritual counsellor, medical psychologist or social worker. We have several spiritual counsellors available at the HMC, with various religious and ethnic backgrounds. You can of course also turn to your GP.
Keeping a ‘diary’ may also help to process your stay in the ICU. Your partner or a family member can write down the events that occurred during your stay in the ICU in this diary. Patients often have little to no recollection of this period. A diary can help patients to fill in the gaps in their memory after having been discharged from the ICU. Keeping a diary can also help family members, albeit in a different way, as it enables them to channel their experiences by writing them down. If you as a patient have questions about your stay in the ICU after being discharged, or you want to share your experiences, you can always make an appointment with the ICU doctor to talk about your stay in the ICU. You can find our contact details below in this information.
In addition, we organise a discussion meeting for our ICU staff twice a year. We also invite a number of patients and/or loved ones to these meetings, to learn from their experiences in the ICU. An ICU doctor or nurse may invite you to such a discussion meeting. It is up to you whether you wish to attend this meeting.
Suggestions or complaints
During your stay in the ICU, we may ask you to take a short patient satisfaction survey. If you have suggestions or compliments, please pass them on to us. This will help us to continue to improve our care.
If you have a complaint about the care you received in the ICU, please submit it to the ICU’s care manager. You can make an appointment with the care manager by calling the administrative office on 088 979 21 19.
If your complaint is not resolved to your satisfaction following this meeting, please contact the complaints officer for the relevant HMC hospital. For the complaints officer for HMC Antoniushove, call 088 979 40 44.
For the complaints officer for HMC Westeinde, call 088 979 18 18.
If you have any questions after reading this information, you can always pose them to the nurse.
You call our ICU locations on the following numbers:
ICU at HMC Antoniushove: 088 979 44 27
ICU at HMC Westeinde: 088 979 21 19
For more information, you can also refer to the website of the Dutch organisation for current and former ICU patients and their loved ones (only available in Dutch): www.icconnect.nl. More information about our ICU can be found on our website: www.haaglandenmc.nl/specialismen/afdeling/intensive-care-ic. If you would like to know more about your rights and obligations as a patient, please see our information about your rights and obligations (only available in Dutch). This information is available on our website and you can also request it from the ICU.