What is an average day like?
An average day is busy and intellectually
challenging. A day typically starts with a multidisciplinary round
of all patients and the review and development of individual
treatment plans. Junior staff are allocated appropriate tasks and
senior staff undertake a combination of teaching and complex
practical procedural tasks. They also liaise
with clinical colleagues and relatives as
Complex patients are seen as often as required, and a second round
usually takes place late in the afternoon – with a review of
treatment plans for the evening. Many consultants work combined day
and on-call sessions with junior staff increasingly working
What are the hours like?
Consultants work full-time or part-time with
another specialty interest such as anaesthesia or surgery. They
typically are on call for one in five shifts with junior staff
increasingly working day, late and night shifts. Staff can be based
in one or more critical care units, high dependency units or with
patients on the wards as part of an outreach programme.
What people work in the same team?
The team comprises:
- Critical care nurses.
- Pharmacy staff.
- Microbiology staff.
- Ward clerks.
- Secretarial staff.
- chaplaincy staff.
Specialists also work with staff from other
clinical disciplines, including surgery, general medicine and
Types of patients
Intensive care specialists give post operative
treatment to critically ill patients post-operatively from all
specialties. They also treat pneumonia, severe asthma, liver
and renal failure, heart failure and head injuries. Specialists
would typically see approximately 12 to 25 patients a day.
What is most enjoyable?
Working as part of a team and meeting the
challenges presented by the critically ill patient is seen by most
as rewarding. Other enjoyable aspects include seeing critically ill
patients improve to discharge, and the interface between technology
and clinical skills.
What is most challenging?
The management of treatment withdrawal and
grieving relatives is challenging, as is the management of a
multidisciplinary team with many senior members.
Opportunities for flexible working
Flexible training is possible, particularly if
undertaken as part of anaesthetic training.
Opportunities for research and teaching
Opportunities within intensive care are almost
unlimited. Active research and audit opportunities exist in
most critical care departments, at national and international
level. Most units will have extensive teaching programmes for all
grades of staff from every discipline. Multidisciplinary
teaching is very much encouraged.
Opportunities other than consultant-level work
The main changes over the last few years have
- the introduction of critical care outreach teams, which bring
the skills of critical care to patients on the hospital wards and
assist in earlier detection of patients at risk
- the introduction of care bundles to improve the management of
severe sepsis and to reduce complications such as
ventilator-acquired pneumonia and thromboembolic disease
- the introduction of widely available diagnostic imaging
- the introduction of increasingly sophisticated physiological
There is potential for significant expansion
for staff and associate grade doctors as well as the development of
basic and advanced critical care practitioners.
Quote from an intensive care medicine specialist
‘I became a consultant in intensive care
medicine because I found the mix of team working, applied
physiology, application of advanced technology and practical
procedural skills to be irresistible. Seventeen years later I have
not been disappointed and I continue to find many areas just as
challenging as when I started.’