LEADING AN ICU TEAM

Dr James Bromilow is the lead consultant for intensive care at Poole Hospital in England. With 12 years’ experience in this role, he tells us about the unpredictability each day can bring

WHAT IS A DAY IN THE ICU LIKE?

The day is split between looking after patients who are already admitted to the ICU and assessing those on other wards who might need admitting. We can get called to all sorts at any time, from a nine-day-old baby to a 99 year old, from someone with a heart problem to a road traffic accident – it’s unpredictable. Patients come to us at all times of the day or night. Every day is different and every day represents different challenges for us.

HOW MUCH DOES A VARIED TEAM OF SPECIALISTS HELP?

Generally intensive care doctors are quite good at dealing with problems with most parts of the body, but when we have a particular specialist problem, we ask our colleagues in other areas to see the patients and help us with their management. Second opinions and further advice can make sure that what we’re doing is right.

HOW HAS POOLE HOSPITAL’S ICU COPED DURING THE COVID-19 PANDEMIC?

At the beginning we just didn’t know how big the surge of patients was going to be, and we didn’t know when that surge was going to come. We didn’t know how to treat patients with COVID because we had never seen that before. COVID behaves slightly differently to other viruses with similar reactions, so we had to learn quickly. We were lucky that our surge came two or three weeks after London’s. We got information on a daily basis of how the doctors and nurses were treating these patients and that informed the way that we did things. PPE kept our staff very safe. We got low in stocks in the early phases, but thankfully never ran out.

WHAT’S THE MOST CHALLENGING ASPECT OF THE JOB?

Sometimes you have to accept that a patient isn’t going to get better, despite your best efforts and treatments. We often have difficult conversations with patients and their loved ones to tell them that the patients aren’t going to get better. Then we have to prioritise treating their symptoms, making sure we give them a dignified end to their life. It’s a big responsibility, but something we’ve trained for for many years. It took me 18 years from starting medical school to becoming a consultant. It’s never a responsibility that we take lightly. Equally, it can be the most rewarding job when people come in very sick, and within a matter of hours, days or weeks you can get them through their really critical stage and onto the road to recovery. It can be a very gratifying job.