{"id":2971,"date":"2025-08-02T11:37:51","date_gmt":"2025-08-02T10:37:51","guid":{"rendered":"https:\/\/blogs.bmj.com\/ebn\/?p=2971"},"modified":"2025-08-02T11:49:29","modified_gmt":"2025-08-02T10:49:29","slug":"seeing-beyond-the-bedside-a-psychology-students-research-internship-journey-on-picu","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/ebn\/2025\/08\/02\/seeing-beyond-the-bedside-a-psychology-students-research-internship-journey-on-picu\/","title":{"rendered":"Seeing Beyond the Bedside: A Psychology Student\u2019s Research Internship Journey on PICU"},"content":{"rendered":"

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This week’s blog is written by NIHR undergraduate intern, Abi Steward, who will be commencing an integrated Master\u2019s programme at the University of Birmingham @UoB_SoP in September. Abi was supervised by Sam Finn and Helen Winmill, and the PICU Research Team.<\/p>\n

Seeing Beyond the Bedside: A Psychology Student\u2019s Research Internship Journey on PICU<\/u><\/strong><\/p>\n

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 \u2013 procedures, violent bleeping, and even staff communication have been identified as sources of acute psychological stress1<\/sup>. Yet despite growing evidence of these triggers, support for families remains limited2<\/sup>. While some one-on-one appointments exist, reviews show that this support is often restricted by staff training and expertise3<\/sup>.<\/p>\n

That\u2019s what drew me, a psychology student, into a funded NIHR undergraduate research internship<\/a> @NIHRresearch during the summer of 2024, on one of the UK\u2019s busiest PICUs. It might seem an unlikely place for someone without a clinical background \u2013 but that\u2019s exactly why the experience was so powerful.<\/p>\n

Observing the Emotional Landscape of PICU<\/strong><\/p>\n

During my four-week internship with the PICU Research Team at Birmingham Women\u2019s and Children\u2019s Hospital NHS Foundation Trust, I conducted a service evaluation exploring how families receive psychological support during their child\u2019s 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.<\/p>\n

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: \u201cHow are you really feeling?\u201d.\u00a0 Witnessing these emotions unfold in real time was one of the most valuable experiences \u2013 something difficult to capture through data alone.<\/p>\n

A Moment that Struct with Me<\/strong><\/p>\n

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\u2019s 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.<\/p>\n

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 \u2013 from nurses to consultants \u2013 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.<\/p>\n

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.<\/p>\n

What the Project Found<\/strong><\/p>\n

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 \u2013 both on the referral process and on supporting families more broadly.<\/p>\n

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\u2019s medical notes. In response, several recommendations were made, including, but not limited to:<\/p>\n