The doctors working in the ICU have different levels of experience. Doctors who are called “residents” are gaining experience in ICU medicine. “Registrars” are often doctors that have chosen to do special training in intensive care medicine. “Specialists” who are also called “ICU Consultants”, are the most senior doctors who work in the ICU.
The ICU doctors are responsible for your overall care and treatment. They also work with and receive guidance from other specialist doctors who visit the ICU. For example, from a cardio-thoracic surgeon visiting a patient after a heart transplant.
Doctors in the ICU constantly monitor how each patient is progressing and will work out the best treatments and actions to take. ICU doctors have the overview of what is happening with each patient and work very closely with the nursing staff. They will also communicate with families and carers to explain treatments, tests and results. When patients are well enough to move to a ward, the ICU team will provide a handover to the ward staff.
In ICU there is often one nurse caring for each patient. Sometimes a nurse will be caring for 2 patients in the ICU. The ICU nurse is highly-skilled and will know about any changes in a patient's condition that need attention.
ICU nurses have a deep understanding of how hard it can be for patients and families in the ICU. Nursing staff will help families to be involved in the care of their loved one. Families and carers are also encouraged to ask questions if they don't understand what is going on.
The nurse coordinator has an overview of each patient's care. They act as a single point of reference for families and carers.
Their role is to:
Dieticians advise on nutrition and feeding for patients in the ICU. They help ensure that patients get the right nutrition they need to recover.
The occupational therapist helps with daily activities such as eating, dressing, washing and toileting.
Many hospitals have a Pastoral Care Chaplain or Spiritual Care Service Team. These people provide support in times of illness and uncertainty and may represent different faiths and traditions. Non-religious patients and families are welcome to talk the Pastoral Care team. They they are trained to work with people with strong faith as well as those with no particular faith.
All types of spiritual counselling can be offered. The Pastoral Care Team can pray with patients and families, offer general support, baptisms, blessings, or just be there to talk. Sometimes patients and families would like a minister from their own faith tradition to visit and a Pastoral Care person can help arrange this.
A Patient Support Assistant is sometimes called a “PSA”. These support workers clean and maintain the ICU environment to a high standard. They help move or transfer patients to other parts of the hospital (for example to the surgical theatres). They also serve patient meals, collect trolleys and help with general tasks.
The pharmacist has expert knowledge on medications. They understand how medications work. They advise on medication doses and side effects. Having a pharmacist on the team has been shown to help prevent drug errors. They assist in tailoring doses of medications for ICU patients. Some ICUs have their own pharmacist. Other hospitals have a pharmacist who visits the ICU.
The pharmacist's role involves:
The physiotherapist helps patients to get moving again. This may involve:
The physiotherapist may also help with breathing exercises. They have techniques to help with coughing and clearing away phelgm.
A psychologist provides mental health support for patients. Feeling scared, sad, confused, angry or frustrated are normal emotions for patients in the ICU. The psychologist can also help family and carers manage these emotions.
Researchers sometimes visit the ICU. They work on projects to help improve understanding, treatments or outcomes for adult patients in the ICU. They may ask for permission to chat with you. You can ask researchers to return at another time if that works better for you.
Being sick and needing to be in the ICU can be difficult and frightening. Social workers support the emotional and practical needs of patients, carers and families. They assist you and your family to access mental health support, financial support and other practical supports.
The speech therapist provides assistance for patients who have challenges with communicating in the ICU. For example, patients who require breathing support may find it hard to talk. Speech therapists also help support patients to make sure they can safely chew and swallow food when they eat.
This topic has been reviewed by an intensive care medicine specialist in July 2022.