When I was applying for the scientist training programme, I knew that I wanted to work in healthcare and the areas of clinical science that interested me but other than that, it’s safe to say that I was pretty lost. So when I stumbled upon critical care science, I was very intrigued. I did as much research as I could into the specialism and luckily it seemed like something that would really interest me, so I applied for the STP, and here we are now!
When doing my research, I did however notice that there was a clear lack of information available on critical care scientists and their role in the clinical setting. So, with the experience that I now have, this is something that I would like to try and change to encourage more people into the critical care scientist role.
‘What does a Critical Care Scientist do on a day-to-day basis?’
This is something that I am often asked by people who have not heard of my role before and it can be a challenging question to answer. The nature of the critical care environment means that every single day as a critical care scientist is completely different, with new and interesting challenges popping up all the time. There are tasks that we carry out very regularly and others that I may not even get to experience during my three years of training, but I hope that I can give you a small insight into the kinds of roles that scientists carry out in the critical care environment.
First thing in the morning, every morning, we perform pre-use checks on all transfer and emergency equipment. This includes ventilators, monitors, suction units and anaesthetic machines. This task, despite seeming menial is vital to ensure that should a patient need transferring to a different ward or taking for a CT or MRI scan, the equipment is known to be working properly, preventing any emergencies when the patient is no longer in the safe environment of ICU.
To ensure that all the equipment is working correctly and nothing has been missed, we complete a checklist for each area or type of device that we check i.e. ventilators, monitoring, miscellaneous items, and A&E. This helps us to remember which devices need checking, and which tests need to be done on each device. This is the first task that my colleagues trained me in when I initially joined, and although it seemed as though there was a lot of equipment to learn about, I found that this was a great starting point as I was able to start using the devices without the pressure of them being connected to a critically ill patient. As I do these checks everyday, I am constantly refreshing my memory in how the checks work and what they are testing, so I am continuously maintaining a high level of competence.
After completing the morning checks, I received a phone call from a nurse on ICU requesting us to set up a Bispectral Index (BIS) Monitor, used to monitor the sedation level of patients. As scientists we are often asked to locate and set up specialist equipment like this. Once I had collected the correct equipment, I set up the BIS monitor on the patient, ensuring that it was working correctly before leaving the nurse to carry out their tasks.
During the COVID-19 pandemic, whenever we go into a bedspace we are required to wear full PPE including gowns, masks, visors and gloves, so setting up equipment can often become fairly time consuming. For this reason, we have to think about all of the equipment we may need to use before we go into the bedspace to prevent us having to remove and reapply PPE multiple times, which is time consuming and wasteful.
Whilst setting up the BIS monitor, I was contacted by another nurse on ICU who required a haemofilter for their patient. Filters are used to do the job of the kidney whilst the patients’ own body isn’t functioning effectively. As critical care scientists, we are in charge of setting up haemofilters and troubleshooting any problems that occur. Due to the high number of patients we are currently looking after, there is an increasing requirement for haemofilters. This means we are constantly keeping up to date on the status of patients, to ensure that enough filters are ready for use when they are required. That morning I had already helped to set up a number of filters in preparation for that need, so I was able to inform the nurse that a filter was already available for her patient.
In regards to troubleshooting, this can be much more complicated as there are a huge number of problems that can occur when using a haemofilter. Most commonly we see problems with access and return pressures, which relate to the pressure of the blood as it is leaving and entering the patient. These can be easy problems to troubleshoot, with simple solutions like changing the position of the patient being sufficient, but often the solution is not so simple and if multiple alarms are voiced by the machine, it can result in a whole new haemofilter being needed. As the therapy being given by these machines is so important, it can become stressful trying to work out what the problem is, in order to facilitate the best treatment for the patient.
In the afternoon our team of scientists were involved in moving adult patients from one unit in the hospital to another, to prepare for the high number of COVID-19 patients being admitted into hospital. As scientists, our role in patient transfers can differ from patient to patient, depending on the situation and the other staff members involved. As a trainee, this is possibly the most difficult scenario to be involved in and can be quite challenging to navigate. There is so much information to take in and understand and it is often a fairly stressful environment.
In general, our role in patient transfers is to ensure that all equipment is working correctly, to assist in the movement of patients from bedside equipment onto transfer equipment, and finally to assist in the physical movement of the patient. In this patient transfer, my role in the team was to be the clean runner, walking ahead of the patient and asking individuals to make room, opening doors with clean hands, and getting access to restricted areas. This prevents other members of the team having to touch the patient and then touch surfaces that may allow the spread of disease, which has become particularly important in the current pandemic. When we arrived at the new unit, we helped with the set-up of equipment at the bedside, making sure that all parameters were being measured properly, before leaving the nurses and doctors to settle the patient into their new environment.
No day is the same as the last
In the little time I’ve spent in critical care so far, the one thing I’ve really noticed is that no day is the same as the last. This has become particularly apparent as a result of the COVID-19 pandemic, as critical care scientists have been relied on more than ever to help provide a service that has been put under enormous pressure, yet continues to save lives.
The truth is, the range of responsibilities that I am going to have to learn and master during my three-year STP programme can seem daunting at times, but one thing is for sure… it definitely won’t be boring!