St George Hospital ICU is an award-winning Level 6 accredited quaternary referral teaching ICU located in South Eastern Sydney. It is amongst the leading centres for trauma in New South Wales.
The St George Intensive Care provides services that include trauma, neurosurgery, cardiothoracic, ECMO and peritonectomy. The unit comprises 52 state of the art single patient rooms separated into 4 pods, and a fully equipped external terrace for both patients and staff to enjoy. Other staff facilities include a tiered lecture theatre, a high-fidelity simulation lab, and meeting rooms with sophisticated audio-visual capabilities. The unit received the ICU Design Citation Award at the 48th Critical Care Congress.
In our ICU, we are committed to excellence in the care of the critically ill, support for their families, education and training of the next generation of care providers and advancing the field of intensive care medicine through high quality research. These are the pillars of our unit, supported by an integrated multidisciplinary team. We value the individuals who make this exemplary care possible and strive to promote a positive culture emphasising Humanity, Harmony and Humility.
Medical Team
We have a diverse Medical Team consisting of 14 Staff Specialists, several VMOs, two Post-Graduate Fellows, and 50 Junior Medical Officers (JMOs) from post-graduate year two and above, including residents, Senior Resident Medical Officers (SRMOs), Trainees (Junior Registrars) and Advanced Trainees (Senior Registrars or Transition Year Provisional Fellows).
The ICU is well staffed around the clock. Each pod team consists of a Staff Specialist, an Advanced Trainee, a Trainee and a resident or SRMO during the day. Overnight, an Advanced Trainee is the senior doctor onsite, with a Trainee and resident/SRMO team in each pod, and the Staff Specialist first on-call.
This is in addition to a 24/7 Outreach Team which consists of a Staff Specialist, a Trainee, and a resident/SRMO. Outreach services include responding to deteriorating patients on the ward (including Code Blues), assessment of potential ICU admissions, a comprehensive TPN service (as part of a multidisciplinary team), and ongoing tracheostomy management.
The Staff Specialist group shares a wide range of non-clinical portfolios including research, quality & safety, nutrition (including home TPN), critical care echocardiography, education, supervision of training, organ & tissue donation, ECMO, tracheostomy, welfare, rostering & recruitment, medication, equipment, outreach services and 3follow-up clinic.
We are dedicated to supporting the Intensivists of tomorrow with a comprehensive training program in addition to broad exposure to general and subspecialty intensive care medicine. We are also committed to positive cultural change and improving the wellbeing of our staff.
Nursing Team
The St George Intensive Care Nursing team comprises over 220 nursing staff. The unit is made up of 4 pods through which all staff rotate into every 3 months to ensure staff are skilled in all aspects of critical care nursing, and to enable staff to develop good relationships with all members of the ICU team.
Each pod has a supernumerary Pod Coordinator and ACCESS nurse to support the staff working in single rooms. The in charge on each shift is a NUM 1 who works 12hr shifts 24/7. The Pod Coordinators report to the NUM1 on the shift to update them with changes in the patients during the shift. The NUM1 manages the patient flow and allocation of staff to patients on a shift-by-shift basis.
Registered nurses commencing in ICU are supported by a well-structured orientation program coordinated by the Nurse Educators, as well as supernumerary orientation time and study days. There is a Clinical Nurse Educator in each pod to support staff’s ongoing learning and development as they progress through our Professional Pathway.
As staff progress, they are encouraged to undertake post-graduate studies in Critical Care and gain Clinical Nurse Specialist status. Further opportunities exist to undergo leadership professional development roles in areas such as Education, ICU Liaison, Clinical Emergency Response and Management.
Staff can work on either an 8 or 12 hr roster pattern which is negotiated with the Nurse Manager at time of employment.
Wellbeing is very much a part of our ICU nursing culture and there are many opportunities to contribute to and participate in a variety of activities.
Nursing Research is an important aspect of development of Intensive Care Practice and is well supported within the department.
Physiotherapy Team
The St George Intensive Care (ICU) physiotherapy team is a dedicated highly skilled team specialised in treating critical care patients in neurology, neurosurgery, trauma, general, complex abdominal surgeries (e.g., peritonectomies) and cardiothoracic surgeries. This is a seven-day service, with prioritisation of treatments given to our most acute patients over the weekend. Our clinical specialist seniors, who lead the team throughout the week, possess postgraduate degrees and education in advanced cardiorespiratory physiotherapy. They have decades of experience in treating patients within the acute setting in teaching hospitals across, not only Australia but also in Europe and the United Kingdom. Their professional memberships included both the Australia Physiotherapy Association (APA) and the Chartered Society of Physiotherapy, UK (CSP). They are active participants in professional development and education within these associations.
Within our modernised purpose-built ICU unit, we are well-equipped with the latest technology for early mobilisation and rehabilitation of our critical care patients. These include a walking ceiling hoist, MOTOmed (computerized upper/ lower limb cycle), Cough-Assist devices, Sit-to-Stand lifters and tilt-tables. Such equipment helps meet our goals for early mobilisation and rehabilitation.
In addition to the evidence-based practice performed by the St George Physiotherapy team, our physiotherapists have participated in international and national research studies and publications.
Social Work Team
The ICU Social Work team is a dedicated 7 day a week service with after-hours Social Workers available. We work with patients, their families and their carers to navigate the often distressing and overwhelming ICU environment. We provide counselling and practical support throughout their hospital admission and assistance with family conferences, financial concerns and discharge planning. We provide counselling in the areas of bereavement, crisis intervention, trauma and new diagnosis, adjustment to illness, organ donation, domestic violence and child protection. We participate in research and education for medical, nursing and allied health particularly in the areas of communication workshops and simulation training. There is an Aboriginal Health Liaison Officer for our Indigenous patients and their families and carers.
Dietitian Team
The Critical Care Dietitian is an important part of the multidisciplinary team within the Intensive Care Unit (ICU). The Dietitian has specialised skills and knowledge in critical care so they can provide appropriate nutrition and dietary support to patients during their admission to the ICU. There are multiple factors which can impacts on a person’s overall nutrition status and wellbeing, and an individual’s nutrition and dietary needs change as their medical condition changes. The Critical Care Dietitian will make sure that individuals are receiving the right amount of nutrition (including macronutrients, vitamins and minerals) which will help in recovery and rehabilitation. If an individual can’t eat or drink enough to get the nutrients they need, enteral nutrition (also known as tube feeding) or parenteral nutrition (providing nutrition via the bloodstream) may be recommended.
Reduced feelings of hunger, changes in taste, nausea and fatigue are common symptoms that people experience when they are in the ICU and may make it hard to eat and drink enough calories, protein and fluid. The dietitian can provide advice, education, and support on how to meet individual nutrition needs.
Pharmacy
Daily medication review is an essential function carried out by the ICU Pharmacists, with a primary focus on ensuring medication safety. In the life-critical environment of the ICU, the participation of an ICU Pharmacist in both medication and clinical reviews is indispensable. This is particularly true given the complex and rapidly changing conditions of critically ill patients. These conditions demand careful attention to detail and a deep understanding of pharmacology to real time adjustment of treatment plans. Beyond ensuring the timely supply of medications and managing stock levels in the Automated Medication Dispensing Unit (AMDU), ICU pharmacists play a vital role in enhancing medication safety. Their efforts are not only focussed on preventing adverse drug events but also on optimising drug therapy to improve patient outcomes. By optimising drug costs, they contribute significantly to cost containment which is crucial in a resource-intensive setting like in ICU. Studies have shown that the involvement of ICU Pharmacists leads to reductions in both mortality and morbidity. Through their daily medication reviews, ICU pharmacist have successfully identified and prevented numerous potential medication errors, ensuring that patient safety remains the top priority. At St George Hospital ICU, we are fortunate to have a highly experienced team comprising a Senior Antimicrobial Stewardship (AMS) & Critical Care Pharmacist, along with two dedicated clinical Pharmacists, who collectively oversee all pharmacy-related activities. Their expertise is vital to maintaining the highest standard of care in our ICU, ensuring that every patient receives the safest and most effective pharmacological treatment.