Written by u-Care postdoctoral researcher Syam Mohan

Through an NHS Lothian observer placement, I was able to spend a half day in the Critical Care Unit of the Edinburgh Royal Infirmary, which was a truly enlightening experience. Dr Craven, a critical care consultant, kickstarted the day by outfitting me in a scrub uniform. The hospital boasts a critical care unit with 42 beds, and within the unit room I was escorted to, Dr Craven was overseeing ten patients.

The day commenced with the “handover” process, a crucial event where a team comprising junior doctors, advanced critical care practitioner (ACCP) nurses, and staff nurses transferred patient files and information to the morning shift team. After this, Dr Craven assigned me to shadow the ACCP nurse. The first patient we encountered was a person with multiple organ failure who relied on life-supporting machines. The ACCP nurse and I began by consulting the staff nurse at the patient’s bedside. After gathering information, the ACCP nurse meticulously assessed the patient, documenting their findings using NHS software. Throughout this process, I received detailed explanations, although some aspects remained beyond my comprehension.

The ACCP nurse and other professionals dedicated approximately an hour to each patient, ensuring they received the highest quality of care. At this point, I realized the incredible dedication of the staff nurses who diligently monitored machines and recorded readings at regular intervals. Their work seemed disproportionately undervalued in comparison to its significance within the healthcare system.

During a brief break while the ACCP nurse attended to another patient, I took a moment to enjoy a cup of tea. Half an hour later, Dr Craven asked me to join a surprising aspect of the day – a comprehensive patient review. This involved the ACCP, consultant, advanced dietetic practitioner, junior doctor, charge nurse, and myself, as well as the pharmacist and the nurse responsible for each patient. It was a thorough discussion covering virtually every aspect of each patient’s condition. Everyone contributed valuable insights, with the ACCP and junior doctor taking the lead, and the nurse at the bedside providing vital input. Dr Craven, as the consultant, carefully considered and integrated each opinion. The teamwork and professionalism displayed during this process left a lasting impression.

The review process was meticulous and time-consuming, lasting until well past one o’clock. At that point, I had absorbed a wealth of knowledge and decided it was time to conclude my visit. I removed my scrub uniform, bid farewell to Dr Craven, and returned to my office. It was an extraordinary and eye-opening experience. As someone without medical training, I recognized the rarity of this opportunity and felt privileged to have witnessed the exceptional dedication and teamwork within the Critical Care Unit.

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