This week’s blog is written by NIHR undergraduate intern, Abi Steward, who will be commencing an integrated Master’s programme at the University of Birmingham @UoB_SoP in September. Abi was supervised by Sam Finn and Helen Winmill, and the PICU Research Team.
Seeing Beyond the Bedside: A Psychology Student’s Research Internship Journey on PICU
In the whirlwind of critical care, it is easy to overlook the silent trauma unfolding just beyond the bedside. For parents of children on a Paediatric Intensive Care Unit (PICU), the experience can be emotionally devastating – procedures, violent bleeping, and even staff communication have been identified as sources of acute psychological stress1. Yet despite growing evidence of these triggers, support for families remains limited2. While some one-on-one appointments exist, reviews show that this support is often restricted by staff training and expertise3.
That’s what drew me, a psychology student, into a funded NIHR undergraduate research internship @NIHRresearch during the summer of 2024, on one of the UK’s busiest PICUs. It might seem an unlikely place for someone without a clinical background – but that’s exactly why the experience was so powerful.
Observing the Emotional Landscape of PICU
During my four-week internship with the PICU Research Team at Birmingham Women’s and Children’s Hospital NHS Foundation Trust, I conducted a service evaluation exploring how families receive psychological support during their child’s admission to PICU. This included reviewing psychology referrals made between January and August 2024 and exploring staff understanding of the referral process through questionnaires and interviews.
Above all, the project gave me a unique opportunity to observe the emotional and unpredictable environment on PICU first-hand. Families on the unit often face extended periods of uncertainty that predispose them to significant psychological distress. Being present on the unit as a psychology intern, with no clinical responsibilities, meant I had the freedom to ask a simple but often overlooked question: “How are you really feeling?”. Witnessing these emotions unfold in real time was one of the most valuable experiences – something difficult to capture through data alone.
A Moment that Struct with Me
One particularly memorable moment was observing a surgical procedure on a premature baby taking place at the bedside. For this, the PICU space was transformed into a sterile operating theatre, requiring all parents and families to leave the unit and temporarily separate from their child. This vividly highlighted how clinical events can impact families, further emphasising the importance of timely psychological support throughout a child’s admission. Despite my non-clinical background, I was welcomed into the surgical area by the lead surgeon and invited to observe from the head of the bed. The contrast between my experience and that of the clinical team was stark – yet I was never made to feel out of place.
However, the support I received from staff extended beyond observing a surgical procedure. Throughout my time on PICU, I was consistently supported by the multidisciplinary team. Staff across all roles – from nurses to consultants – took time to involve me in discussions and explain procedures in a way that enhanced my understanding. From medical debriefs post-death on the unit, to administering medication, I was struck by their professionalism, compassion, and commitment to family-centred care.
Although PICU can be a challenging environment, I found it to be one of warmth, inclusion, and dedication. Importantly, I came to realise that a psychologist is just one of many professionals providing vital support to families.
What the Project Found
The findings from the service evaluation highlighted key areas for development in the referral process to psychology on PICU. While many staff reported feeling confident in identifying when a parent may need psychological support, 82% did not know how to make a referral. Additionally, 92% expressed a need for further training – both on the referral process and on supporting families more broadly.
Staff feedback also revealed that the referral system is largely child-centred, making it difficult to refer a parent directly. This presents both logistical and confidentiality challenges, as referrals for parents are often stored within the child’s medical notes. In response, several recommendations were made, including, but not limited to:
- Clearer referral pathways
- Dedicated and more frequent staff training days
- Broader efforts to de-stigmatise psychological support for families e.g., information booklets
These recommendations are now being considered as part of ongoing quality improvement efforts on the unit.
Skills, Growth and New Opportunities
Beyond the project outcomes, the internship significantly contributed to my personal and professional growth. I developed core research skills in data collection, analysis, and critical evaluation, alongside communication skills through interviewing staff and presenting findings. Working in a multidisciplinary environment helped me build confidence, adaptability, and a better understanding of how psychological research can support clinical decision-making.
I also gained a deeper appreciation of the emotional and ethical complexities of working in a paediatric intensive care setting. These experiences have been invaluable – not only in shaping my future career goals, but also in contributing to my successful application to the integrated master’s programme at the University of Birmingham. This takes me one step closer to becoming a clinical psychologist and potentially returning to Birmingham Children’s Hospital as an honorary assistant psychologist for a six-month placement.
A Final Reflection
This internship has been one of the most inspiring experiences of my academic journey so far. Coming into a clinical environment without a nursing or medical background, I wasn’t sure what to expect – but I left with a renewed sense of purpose and belonging. The experience showed me that diverse perspectives, including those from psychology and other allied disciplines, have a crucial role to play in healthcare research and service development.
Being part of this project not only helped me grow in confidence and skill but opened doors I hadn’t imagined. I am incredibly grateful to Dr Hollie Richardson and the PICU research team including mentors Helen Winmill and Sam Finn @BWC_NHS for welcoming me so openly, and to Professor Kerry Gaskin @GaskinKerry for the opportunity to share my experience through this blog. Even being invited to write about the internship has been a valuable part of the journey – a reminder of just how far a single opportunity can reach.
References:
- Woolgar FA, Wilcoxon L, Pathan N, Daubney E, White D, Meiser-Stedman R, et al. Screening for Factors Influencing Parental Psychological Vulnerability During a Child’s PICU Admission*. Pediatric Critical Care Medicine. 2022 Jan 26;23(4):286–95.
- Bedford ZC, Bench S. A review of interventions supporting parent’s psychological well‐being after a child’s intensive care unit discharge. Nursing in Critical Care. 2018 Dec 10;24(3):153–
- Aljabari S, Birisci E, Kummerfeld F. Provider’s Perception of Parental Anxiety in the Pediatric Intensive Unit. Cureus. 2022 Aug 30;14(8).