My name is Matt, I am one of several doctors working on the unit under the guidance of the ITU Consultants. Having graduated from medical school and successfully completed my years as a Foundation Doctor I am now undertaking speciality training in Anaesthetics and Intensive Care.

Although every day working on ITU is different, they all follow the same basic structure. We arrive at 0800hrs and receive a brief handover from the doctor who has been working overnight, after which we allocate all of the patients on the unit to specific doctors. We then review our allocated patients, examining them fully, identifying key issues and troubleshooting where possible.

At 1000hrs we take part in a formal ward round with our consultants, where important decisions regarding treatments, and plans for the ongoing care of the patients are made. It also gives the nurses an opportunity to raise issues that we may have not fully appreciated. Depending upon the complexity of the patients we have, and the number of patients we have at any given time, this process may take several hours.

Having finished the ward round, we act upon the plans made by our consultants. This may include ordering scans and X-rays, discussing our patients with other specialist teams, updating patient relatives and arranging ward beds for those patients who are well enough to leave the unit.

At 1700hrs we reconvene with the consultants, and have another ward round. The second ward round is typically more brief, checking that all the jobs have been done, and coming up with clear plans for the overnight care of our patients.

Additionally, each day one of the doctors is scheduled to be on call. When that happens we carry a pager and respond to all emergencies throughout the hospital, and those being brought into the Emergency Department. This will include patients who have become critically unwell, and may include those in cardiac arrest. Our role in these circumstances is to attempt to improve the patient’s clinical condition to allow them to be transferred to an area of definitive care. This may include a trip to the Operating Theatre or CT Scan prior to transfer to ITU. On occasion the patient may require transfer to another hospital for specialist management, and it is the role of the on call ITU doctor to facilitate these transfers. This aspect of our job requires us to work closely with other specialties in addition to the Critical Care Outreach Sisters, and in my opinion is one of the most exciting and rewarding aspects of the job.

Between the end of the 1700hrs ward round and handing over the night shift registrar, the on call doctor takes responsibility for acting upon the plans made during the ward round, reacting to new investigation results and admitting any patients requiring ITU care. The night team begin their shift at 2000hrs. They receive the emergency pager from the day on call doctor, and a brief handover of all the patients on the unit. They then continue the care of the ITU patients into the night, handing over to the day team at 0800hrs. As a result there is an ITU registrar on the unit at all times, day and night.