Witnesses Of Life
Have you visited any Intensive Care Units (ICUs) before? Even if you have not, you may have had a glance of them on television programmes. What impression have ICUs given you? Mysterious? Deadly?
Young Post meets Bridget Chan, a doctor working at the ICU of Prince of Wales Hospital, to have a closer look at ICUs as well as the work of ICU doctors.
Qualifications
The first step of becoming an ICU doctor is of course to obtain a degree in Bachelor of Medicine and Bachelor of Surgery just like all other doctors. The second step is to become a fellow of either Anaesthesiology or Medicine. Then, specialist degrees in Intensive Care, Cardiology, etc. are needed. Usually, an ICU doctor has one to three specialist degrees. Just like Chan, after getting a degree in MBChB, she worked on to become a Fellow of Hong Kong Academy of Medicine (Medicine) while working as a doctor, afterwards, she gained specialist degrees in both Critical Care Medicine and Respiratory Medicine through four years of further studies and training. Still, Chan admits there are much more to learn as there are new discoveries continuously, and she needs to update her knowledge from time to time for the sake of the health of patients. There is no easy way to become an ICU doctor.
Requirements
An ICU doctor should be professional and decisive at all times. There are lots of machines operating in ICUs, however, beeping does not necessarily indicate that a patient need further treatments. ICU doctors need to consider whether a patient requires help by looking at and interpreting the reading of apparatus, such as the vital signs including pulse, blood oxygen content, blood pressure, intracranial pressure and respiratory rate, making use of their expertise. Emergencies can happen in ICUs at any moment, for instance, a patient may suddenly get cardiac arrest. When coping with such situations, ICU doctors need to make the right decisions quickly, including knowing the problems suffered by the patients, providing them with suitable treatments… The life of patients is at risk and whether they can stay alive or not depend heavily on ICU doctors. If any mistakes are made, no matter big or small, or the decisions are made late, it may lead to the death of patients. To be a responsible ICU doctor, professionalism and decisiveness are crucial.
An ICU doctor should also be patient and caring. When patients get into ICUs, their situation is really bad. And seeing patients suffering and seemingly dying, the relatives are much more worried than those in other departments. Sometimes, when the machines beep once or the readings of them changes a bit, they already chase after ICU doctors for help. ICU doctors need to understand that the relatives do not have professional knowledge and are really anxious, and then explain to them the condition of patients and how the apparatus work to relieve their tension. And death does happen in ICUs, and maybe of the greatest number, although about eighty percent of patients can leave ICUs. The relatives of dead patients are in the state of squeamishness. Even though ICU doctors are not responsible for comforting the relatives, speaking in a warming voice can become a comfort. To be a good ICU doctor, patience and a warming heart is essential.
Of course, an ICU doctor should love taking up new challenges. ICUs are places where nobody can predict what will happen in the next second and challenges pop up. According to Chan, conservative people can hardly become an ICU doctor because not any ICU doctors can escape from challenges and making changes.
Work Prospects
As Chan stresses, being an ICU doctor, saving the life of people is the ultimate concern, salary is not quite meaningful.
Attaining advanced knowledge can be one of the work prospects of an ICU doctor. ICU doctors often get to know the latest knowledge faster than doctor of other departments. Chan gives the example of extracorporeal membrane oxygenation (ECMO). ECMO was first used in 2009 for curing human swine influenza patients in ICUs. It was a rather new technology at that time and ICU doctors were those trying ECMO at the beginning. It is an exciting experience to be among those getting their hands on advanced equipment first, tells Chan.
Being promoted to be the head of the department can be a long-term prospect. However, along with promotion, the workload is increased as well. The head of ICUs may be called for work outside their working hours, for example. Though, being the head is much a great honour.
A Day At Work
In television programmes, it is said that doctors have to on call for thirty-six hours. However, it is not the case for ICU doctors. The normal working hours of ICU doctors is sixteen hours, during weekends, it is twenty-four hours. The work of ICU doctors starts with discussion of the situation of patients with doctors of the earlier round. After that, they examine the patients one by one. When needed, they adjust the treatments given to patients to improve their condition. Besides taking care of patients in ICUs, ICU doctors need to do consultation in other departments. They also need to take care of serious cases in Accident and Emergency. In the evening, they have to talk to the relatives of patients to let them know the latest situation. Being an ICU doctor is no easy job, says Chan, it requires lots of stamina, but seeing patients getting better, all hardships are worthy.