The intensive care unit (ICU) is a specialized hospital ward where people with life threatening conditions receive around-the-clock monitoring and life support. It is here that the sickest of the sick patients are managed, and there is a large spectrum of challenging working conditions that may cause significant psychological stress to those who function in them. There is a growing body of evidence supporting the increasing prevalence of mental health issues among the medical fraternity. The notion of professional burnout syndrome in the intensive care specialty is well described in the literature and is perceived to be due to the workload and acuity of the field.
Between 2018 and 2021, researchers interviewed 45 experienced Intensivists from 7 hospitals in 3 countries, asking about the stressors of working in the ICU, and how they were able to manage the effects that these stressors had on them personally, whilst continuing to work and function. Personal recounts were transcribed, reviewed, and qualitatively analyzed in order to identify regular stressors, common responses, and the manner in which deleterious effects were mitigated. One of the overarching themes to emerge from the data was that there was little support provided for doctors in the ICU and the potential for stigma for those seeking such support was high. This work generated seven peer-reviewed manuscripts, and while these papers scratched the surface of some issues that emerged, the need for a deeper exploration and articulation of the rich dataset was evident.
Contemplating the Role of the Intensive Care Doctor brings together an experienced group of intensivists and other clinicians to provide further commentary related to the observations and generous reflections of those interviewed. The main focus is on the need for young doctors to contemplate their own personality and the intensive care environment itself to prepare themselves to work within the specialty and have longevity and good health while doing so.
The book is comprised of eighteen chapters that explore personality traits, various allocations of role, the working environment, and the complex nature of communication between peers, teams, and families. It aims to facilitate the resilience of young doctors by challenging their perception of themselves and of those around them. We hope that by exploring these narratives, these doctors will be better prepared to manage their potential vulnerability within the ICU medical team.
Part 1: User guide to this book.- So, you want to be an ICU doctor? How
this book might be useful for an ICU trainee.- Thinking about thinking - how
this book might be useful related to communicating in ICU.- Connecting people
- how to use the book in a mentoring relationship.- Doing whats right, but
whats right? How this book might help to prepare for ethical dilemmas in
ICU.- Balancing insight with serenity - how to use the book to self-reflect
but not ruminate.- Part 2: Swimming lessons.- Can you swim? Contemplating
your personality.- Floating, treading water, and swimming - contemplating
your role.- The stormy sea - contemplating the place.- Nearly drowning,
diagnosing bias - contemplating societal biases.- Swimming in new waters -
contemplating the ICU environment after a pandemic.- Part 3: Learning to
sing.- Singing from the same songbook - contemplating communicating with
family.- Melodies and harmonies - contemplating communicating with other
doctors.- Different performances, kids are special - contemplating paediatric
ICU.- Leading the choir - contemplating communicating with your own team.-
Part 4: Mastering aerial acrobatics.- Learning to climb the ropes - shadows
of doubt - contemplating self-care.- When ropes get tangled - contemplating
change.- Installing safety nets - contemplating our fieldwork guide.-
Bouncing safely ahead - contemplating the future.
Diane Dennis BSc, PhD, FHEA
Head of Physiotherapy Department
Sir Charles Gairdner and Osborne Park Healthcare Group, Nedlands, 6009, Perth, Western Australia, Australia
Peter Vernon van Heerden, MBBCh, MMed(Anaes), PhD
Department of Anesthesiology, Critical Care and Pain Medicine
Hadassah Medical Center, Jerusalem, Israel
Michael Ruppe, MD
Division of Critical Care, Department of Pediatrics
University of Louisville, and Norton Childrens Medical Group, Louisville, KY, USA