Explain the organisation of the intensive care unit?
The following kinds of professional groups are required in the day to day functioning of a modern intensive care unit:
The director or Head of Department responsible for the clinical and administrative management of the ICU.
A team of doctors with special skills and training who are available to provide bedside care 24 hours a day (this might include seniors doctors in training).
A Chief of Nursing Services.
Nurses with at least some level of intensive care experience to provide bedside care round the clock. This is an area of grave concern globally as there is a considerable shortfall of qualified nursing staff available. Ideally, the nurse to patient ratio should be 1:1 for all patients on life support or otherwise unstable. Indeed, there may be occasions when more than one nurse may be required to look after a very sick patient. A 1:2 ratio might be more appropriate for stable patients. Allowing for time off, leave, etc, this would work out to roughly four nurses for every ICU bed - in other words, a 10 bedded high acuity unit would require a minimum of 40 nurses.
Ancilliary staff - this would include cleaners, patient care assistants, etc. of particular relevance to an intensive care setting would be grief counselors and social workers to look after the emotional and social needs of the family.
The ICU secretary responsible for administrative matters of the unit.
Needless to say, intensive care medicine is all team effort where every member of the team has a very important role to fulfill. Outcomes have definitely been shown be superior in such structured units - the ICU physician being involved in all aspects of patient care and acting as a decision maker - much like the "captain of a ship". Protocols need to be in place for all aspects of patient care. There should also be regular update of knowledge for nursing and medical staff at regular intervals to keep in touch with what is new.