Patients in intensive care need support from professionals with a wide range of skills to address every aspect of their condition, as well as continuous monitoring day and night.
That is why intensive care teams are so large. Depending on the unit, there is generally one nurse for every two to three patients and one nursing assistant for every four to six patients. There are also many doctors, who rotate more frequently than in other departments because of the large number of on-call shifts they have to cover. A medical team is always present in the intensive care unit to respond to any situation.
This page presents the wide range of professionals you may meet in intensive care. The exact team varies depending on the unit, its specialty and the way the hospital is organised, so not every intensive care unit includes all of these roles.
The head of department leads all the doctors you will meet in the unit. They are responsible for clinical activity and the unit’s overall direction.
Clinical practice refers to medical care provided at the patient’s bedside. The term comes from the Greek word “klinē”, meaning “bed”.
These are qualified doctors whose work is based in a care unit. They set the daily treatment goals for the patients in their unit. In many departments, doctors take turns providing bedside clinical care. When they are not assigned to clinical duties, they may work across the department, teach and/or conduct research, particularly in university hospitals or departments that train residents and medical students. Some also carry out dedicated research.
Residents are doctors who are still training and specialising. You will find them in university hospitals (CHUs) and in other hospitals with teaching departments. They spend a great deal of time in the unit and are often on the front line, making them important contacts for patients and their relatives. They provide continuous medical monitoring and prescribe treatment under the direct supervision of the senior doctor responsible for their unit. They also help maintain continuity of care during night shifts, always with the support of a more experienced doctor.
Nurse managers are generally nurses with a master’s degree in management and/or a nurse manager qualification. They supervise and coordinate the care team. They oversee quality of care and the management and coordination of staff and equipment. They are responsible for organising the unit so that patients receive the best possible care. Their role includes training and supporting teams, implementing departmental projects and applying healthcare policies. They can be a valuable point of contact if you need help understanding how the unit works.
Nurses and nursing assistants are present around the clock in the units and patient rooms, providing day-to-day care.
Nurses work in shifts 24 hours a day to look after patients, supported by nursing assistants. Their main responsibilities include:
They play a particularly important role in intensive care because impeccable cleanliness is essential to minimise healthcare-associated infections in these especially vulnerable patients.
They can be invaluable in helping you with the administrative steps needed to free up time to support your relative in intensive care, such as sick leave or compassionate leave. They assess social support needs and coordinate discharge planning.
They ensure that intensive care patients receive nutritional support tailored to their condition. The quality and suitability of this nutritional support are essential to recovery.
They play a vital role in intensive care. They work with patients every day to maintain joint mobility and muscle strength, including for patients who are bedbound or in a coma, using gentle limb movements and bedside cycling equipment. Once or several times a day, they assess and build patients’ muscle strength and ability to breathe independently. By encouraging the respiratory muscles to work, they help patients come off mechanical ventilation sooner. They also play an active part in helping patients get up once they are awake: standing them upright, doing exercises at the edge of the bed and transferring them into a chair as early as possible.
They meet with patients and their relatives to listen and help them through the emotionally difficult stages of an intensive care stay. In some situations, they can liaise with the care team and help ease conflict.
Speech and language therapists in intensive care assess and treat swallowing, communication and language difficulties in intubated, tracheostomised or critically ill patients, helping their recovery and comfort. After intensive care, they may also support the recovery of language, swallowing and memory-related abilities.
Occupational therapists in intensive care help prevent and reduce motor and cognitive complications in critically ill patients, supporting their independence and functional recovery from the acute phase onwards. They work alongside physiotherapists. After intensive care, they can help patients adapt their everyday activities and environment to any temporary or permanent after-effects, promoting greater independence.
In many units, intensive care patients may meet medical, nursing or physiotherapy students who help with monitoring while learning their profession. Their work is closely supervised by members of the team. Medical students in their fourth to sixth years are often referred to in France as externes.
.
They support doctors by maintaining and preparing hospital records, organising medical appointments and carrying out the many administrative tasks that allow the care team to focus on caring for patients.