Learn how the ICU works...
About the Intensive Care:
- We treat critically ill patients from Melbourne and rural Victoria
- This includes those having major surgery, and life threatening conditions of the heart, lungs, kidneys, gastrointestinal or neurological systems.
- There are dedicated specialist doctors and nurses 24 hours per day
Care model:
- St Vincent’s Hospital Melbourne is a teaching and training hospital meaning that there are supervised students and trainees involved with patient care.
- Professional and respectful communication is of utmost importance between team members and with patients and loved ones. However, we are not serious all the time, and often use humour to support each other.
- In addition to the ICU team, each patient is cared for by a ‘parent unit’ specific to their reason for hospital or ICU admission. For e.g. cardiothoracic surgery if having a heart bypass operation or general medicine if coming in with a severe urinary tract infection. These teams visit the ICU and discuss patient care with the ICU medical and nursing teams. When patient are discharged from the ICU to the ward, these teams are responsible for their care.
- Patients and families always have the right to ask questions about their care and we encourage shared decision making when possible. To read about the rights of patients, consumers, and other people using the Australian healthcare system, click here.
- The ICU takes part in research studies so you may be asked to consent for participation in a study.
Staff roles:
Doctors
- ICU doctors operate in a team, led by an Intensive Care Specialist. We have Senior Registrars, Registrars and Residents working in our ICU. The team generally do two ward rounds per day to make plans for each individual patient, and are available in between those times for procedures, emergencies and family meetings. They are skilled in insertion and maintenance of a number of different organ support methods.
Nurses
- ICU nurses also operate in a team from the Nurse Unit Manager, to Associate Nurse Unit Managers and Clinical Nurse Specialists, to Registered nurses. Each bedside nurse looks after either one or two patients providing highly specialised care in line with the overall plan formed by the ICU ward rounds. This includes taking blood tests, monitoring vital signs, administering medications and running specialised life support machines.
Staff roles:
Physiotherapists
- Speech Pathologists help people who have trouble with swallowing (eating or drinking) and communication (talking or understanding). People who have been very unwell often have trouble with communication and swallowing. Speech Pathology may offer different food or fluids to make swallowing safer or provide strategies and equipment to assist with communication. Speech Pathologists are also part of the team who manage tracheostomy tubes and people who have had a laryngectomy.
Dietitians
- Dietitians assess the nutritional status of patients and provide a comprehensive strategy for optimal nutrition. This can include monitoring normal oral intake, nasogastric tube feeding or intravenous feeding (‘Total Parenteral Nutrition’). There are however times when it is not safe to feed patients – e.g. immediately after major bowel surgery.
Staff roles:
Pastoral Care
Coming into hospital is a unique experience for each of us. It may be a time of anxiety, fear and uncertainty. You may find yourself in a state of transition and start to think deeply about your life and what is important to you. Pastoral care is a person-centered and holistic care paying particular attention to a person’s spiritual care and well-being. It is respectful and supportive of all beliefs, religious traditional and cultures. Pastoral practitioners are part of the multidisciplinary team that care for you and for your family and friends while in hospital. You may find it helpful to speak to someone from Pastoral Care Services:
– in times of grief and sadness
– when feeling anxious or fearful
– when needing to make decisions
– during a period of serious illness or at the time of death
– if you are feeling lonely, isolated or would like to have someone listen to your story
– to explore what gives your life meaning and purpose
– to talk about aspects of your belief or questions of faith
– for spiritual nourishment and support through prayer, reflection, blessing or sacraments such as Communion and Anointing
– to arrange for a representative from your faith community to visit you
– to access a sacred text or material for reflection.
Social workers
- Social workers aid patients and families to navigate the complex psychosocial problems that arise when people become critically ill. They often provide a bridge of communication between families and medical staff or government organisations such as Centrelink.
During a patient’s intensive care stay, they will be seen and treated by a physiotherapist. The physiotherapist will see all patients, even those connected to a breathing machine. The physiotherapist’s role can be divided into two main areas – chest physiotherapy and rehabilitation.
The goal of chest physiotherapy is to keep the patient’s lungs clear. This involves preventing the build up of phlegm and ensuring enough air is getting into the lungs. Chest physiotherapy does this through breathing techniques, positioning and mobilisation (e.g. sitting out of bed, walking).
The goal of rehabilitation physiotherapy is to maintain muscle strength and fitness and prevent joint stiffness and muscle tightness. ICU patients can become weak very quickly, losing up to 2% of muscle daily. Physiotherapists manage these problems by getting patients to do exercises and mobilising as soon as possible.
If you or your family member is in the St Vincent’s ICU, please feel free to talk to the physiotherapists to learn more. Or contact the St Vincent’s physiotherapy department on (03) 9231 3805.