An insight into work in the intensive care unit

How would you explain your job to outsiders?

I am responsible for the organisation of the intensive care unit, which includes all personnel management, such as further training and recruitment. For example, we train employees to become intensive care experts as part of a two-year postgraduate course (NDS). I am also the first point of contact for my team and the medical department when it comes to issues such as admission capacities or workloads. I am generally consulted as soon as something concerns the intensive care unit. I am also responsible for compliance with various processes, such as the implementation of nursing guidelines or hygiene requirements, as well as materials management, medical technology, IT, re-evaluation of materials and so on.

My overriding goal is to ensure that the work in my team is carried out as efficiently as possible and at a high level of quality. At the same time, the focus should be on people, i.e. customer-orientation and care for relatives.

You have been working in this profession for over 20 years now, what do you like best about it?

I enjoy and have fun looking after patients and managing people. In our hospital, I particularly appreciate the short communication and decision-making channels. I have a lot of room for manoeuvre here and can play an active role. In my opinion, your own mindset is a decisive factor in being enthusiastic about this profession. For me, these are the 4 M's: "You have to like people". I think it's great to work with many different professional groups.

What makes your job unique?

Because we work with people every day, versatility and variety are guaranteed. Our work requires a lot of specialised knowledge. New medical findings and therapies are constantly being incorporated into everyday nursing care. It's also exciting when a patient is in an acute, exceptional situation, to act together with the doctors, make decisions immediately and then get the patient back to health as quickly as possible. With patients who are treated in the intensive care unit for longer than 5 to 6 days, a closer relationship automatically develops. We work very close to the body and also have a longer "contact time" with them and their environment. We are always happy when we can transfer "almost hopelessly" seriously ill patients to the ward - that is a great success for the entire treatment team.

To what extent has care on the intensive care unit changed over the last 20 years?

A lot has changed. For example, new surgical techniques, better medical knowledge and more advanced interventions have shortened the time patients spend in hospital. There are new sedation drugs and automated ventilation techniques that reduce the hours of ventilation, for example. In addition, the average age of patients has risen. Older patients are more often confused and find it difficult to be monitored in an intensive care unit. Intensive care is constantly evolving, traditional care rituals are outdated, materials are changing and so on. But the sick person in question remains the same. Subjectively, I have the impression that today the family environment, together with the carers, is involved earlier in the therapy and decision-making process.

Are there stereotypical views that are often associated with the intensive care unit and nursing care?

Yes, there are. It is often assumed that all patients in intensive care are ventilated and unresponsive. In this context, you probably remember the COVID pandemic and the staff equipped with coats, protective goggles and bonnets. However, we also have awake and responsive patients who need an intensive care unit for a short time. I also cannot confirm the idea that we are confronted with death and dying more often than other parts of the hospital. The mortality rate is about the same compared to other wards.

How is your team organised and what is the distribution of roles?

Our entire team is very well qualified and has a lot of experience. Almost all of us have a postgraduate qualification in intensive care. Some employees have special tasks, for example they are responsible for our pharmacy on the ward or aroma care. Five different professional groups work for us: NDS intensive care experts, NDS students and HF qualified nurses. In 2007, we were the first intensive care unit in Switzerland to integrate the new vocational training programme for healthcare assistants into our team. We also have nursing assistants to provide further support. In terms of management, we are a 4-pillar team. We have a nursing specialist, this position is currently vacant, then we have a vocational trainer, a deputy ward manager and myself as ward manager.

How do you rate the balance between your professional and private life?

Good, actually, as I've seen a lot at university hospitals over the years. Only very unusual patient situations affect my private life. During the COVID pandemic, however, this was a big issue within the team.

Do you have any particular goals or visions that you would like to pursue?

One goal for me is of course to recruit new employees and maintain the stability of the team. In this context, it is particularly important to secure the future by looking for junior nurses who want to train for this exciting and varied job. Who is going to look after us in an intensive care unit in 10 years' time if there is already a latent shortage of staff?

Another goal is that we would like to become a paperless intensive care unit. The project is called PDMS and stands for "Patient Data Management System". This computer programme documents all patient data such as blood pressure, infusions, ventilation parameters and more in a software programme. Our day-to-day work is influenced by this modification and increases the attractiveness of our organisation. I would like to tackle such challenges together with the team while keeping the fun and laughter at work.