New roles for health-care workers in the open ICU

In some countries, the traditional concept of the ICU as a restricted-access area has given way to a newer "open" ICU model. Freer access to the unit by relatives and visitors has had profound effects on the roles played by health-care workers, rendering them considerably more complex. Care-givers are faced with the need to develop a new mindset, to work effectively under the watchful eyes of the patient's family, and to modify the way they communicate with patients, families, and one another. They are also being asked to take on a host of new responsibilities, including the prevention of patient disorientation, reducing the risk of long-term psychological disturbances (in patients and families), monitoring and educating visitors to ensure their safety and respect of all patients in the unit, and making the transition from "patient-centred" to "family-centred" care. For physicians and nurses working in this new and challenging setting, the most effective strategy for survival and success involves learning to view family members as a valuable resource for improving patient care, rather than an annoying problem. (C) 2014 Elsevier Ltd. All rights reserved.