In this setting, residents develop expertise in managing sepsis, respiratory failure, toxic overdoses and doing invasive procedures, and also in caring for families in crisis and negotiating goals of care in ethically and medically complex situations. Because there are no critical care fellows, residents assume a significant amount of autonomy in the care of patients and work directly with the attending physician to make decisions and execute plans of care.
The day begins at 7 a.m. with signout from the night ICU team to the day ICU team. Work rounds are led by the intensivist and begin at 8:30 a.m. At the conclusion of rounds, the tasks of patient care are undertaken by the day team, including any procedures, consults, transfers, and new admissions.
The Intern critical care experience is split between our two acute care hospital campuses. At Cambridge Hospital one resident and one intern (two interns during the first ¼ of the year) work together with critical care nurses, respiratory therapists and a pulmonary-critical care intensivist to provide care to critically ill patients in a 6-bed ICU. At Everett Hospital one intern works directly under the supervision of a pulmonary-critical care intensivist in a 6-bed ICU. Time each afternoon is carved out for dedicated resident teaching, led by the intensivist.