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Discussion

Do you have intensivists in your unit

do you use intensivists in your unit? Right now we have patients who's admitting docs in the CCU are family medicine, internal medicine, etc. We are researching the possibility of having only intensivists admit to CCU then the internal med guys taking over when the pt is transferred out of the unit. What are your thoughts.

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We have intensivits in the ICU and cardiologists in the CCU.

  • Experts

When I was still working in Detroit, the patients were admitted to their doctors but followed by the Intensivists. Any decision about the patient was discussed with the Intensivist, pertaining to their Critical Care admit. The private doc still saw the patient everyday because they had the longest contact with the family, etc. All orders were discussed with the intensivist before the PMD could write anything.

Hope that this helps.

I once worked in a non teaching facility, all attendings. So you have some general internist who gives crazy vent management, or tries to treat swan readings, although they could bring in an intensivist (pulmonologist).

Now I'm in a teaching facility, still, NO intensivist. but I'm on a heart transplant unit, the transplant team is here 12 hrs. each day, then night float takes over, as little as possible. Many times though we have to call the team, night float just doesn't know our specialty.

On my unit in England, all patients are admitted under the care of the intensivists who then make treatment decisions. Their medical/surgical team may be involved in decisions but the juniors aren't allowed to change medication etc.

Dee P

I'm in a teaching facility and we have a Pulmonary/Critical Care team on dayshift only that works towards better patient nutrition, skin care issues, and vent weaning. There are problems with this system, being that the team rotates not only residents and med students, but attendings as well. Some of them are just incredible doctors and real patient advocates, while others are just a pain in your behind. We have one in particular who will come in a write a truckload of orders, and as soon as you start to carry them out, she'll change her mind and D/C them, only to write a whole bunch more.

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