Working in intensive care (ICU): 5 pros and 5 cons
5 pros
1. Highly controlled and supervised environment
As the name suggests, ICU can be intense, but it is also very organised and controlled. You will be working within a highly focussed and diligent multi-disciplinary team. There is always senior supervision (even on nights) and plenty of learning opportunities.
2. Job satisfaction
Many patients will only need a few days in critical care. However, there are some who need months or even years in ICU. There is huge satisfaction and privilege in treatment and rehabilitation of these patients who very nearly had no hope. Where the stakes are high, the rewards are higher.
3. Variety
You will see a variety of patients from medical, surgical and speciality areas. This provides opportunities to liaise with other teams and broaden your knowledge and exposure into other fields.
4. Transferable skills
Critical care is a great area to upskill and develop professionally. The management of critically ill and deteriorating patients involves many transferrable skills such as advanced resuscitation, advanced airway management and some surgical procedures. You will regularly perform these under full guidance.
5. Excellent resources
If you are a fan of gadgets and new technology, ICU is an exciting environment to work in. There is a wide range of diagnostic and monitoring equipment on hand, to treat and manage patients efficiently. You will often use equipment including bronchoscopy, advanced cardiac monitoring, haemodialysis – and even some laboratory testing equipment.
5 cons
1. Communication with patients is limited!
The majority of patients in ITU will either be sedated and/or have an artificial airway in place to support their breathing. This means you may miss out on the usual conversational banter that is sometimes taken for granted.
2. It can be emotionally taxing
Death and serious illness are common place in critical care. There is a high risk of burn out when dealing with volatile and complex situations, particularly in the young and vulnerable.
High emotional resilience is needed to navigate these situations sensitively and support patients and their families. It is vital you can remain impartial for both yourself and your patients.
3. Reduced work-life balance
Shift work is the norm. You can expect to work 12-hour shifts (including nights) often back-to-back. Rest breaks can often be interrupted as patients are unstable and can deteriorate quickly without warning. You may not always have the best sleep, and subsequently have less energy for social life and other commitments.
4. There will be blood
Most patients in ICU will need invasive monitoring lines and drainage tubes inserted. Wherever there is a hole, there will likely be a tube. This means you will be more exposed to blood and other bodily fluids than in other areas. As with any invasive procedure, appropriate protection and care is required, but risk of contamination can increase when performing more procedures.
5. Little financial gain
Building an additional income may be difficult as there are fewer opportunities for private practice. There are related specialities such as anaesthetics which have greater potential for higher income, but also require longer training.
Summary
We have described working in intensive care (ICU): 5 pros and 5 cons
Written by Vivienne Ebob, WMS Medical Student
