Critical Care at St. Michael's
Each intensive care unit is led by an interprofessional care team that specializes in critical care, including attending physicians, nurses, and specialists to co-ordinate patient care. St. Michael’s Hospital is a teaching hospital, affiliated with the University of Toronto, and we promote an ongoing learning environment.
- A doctor specializing in the care of critically ill patients. While a patient is in intensive care, this is their primary doctor and the leader of the interprofessional care team. This doctor changes every week.
- A resident is a doctor who has completed medical school and is practicing under the direct or indirect supervision of a staff physician for training in a medical speciality.
- A fellow is a doctor who has completed their residency and is now receiving additional training in a specialized area, such as critical care medicine.
- A doctor specializing in providing surgical needs for patients with traumatic injuries. This may include injuries resulting from a car crash, fall, gunshot wound or work-related injury.
- A doctor specializing in brain and spine surgery. This may include brain or spinal cord tumors, brain or spinal cord injuries, or brain aneurysms.
- A doctor specializing in surgical care for the whole patient, including diagnosis, operative and postoperative management of the patient.
- A doctor specializing in medical procedures for the heart, such as angioplasties and minimally invasive valve replacements
- A doctor specializing in heart surgeries such as coronary artery bypass and valve replacement.
Registered nurse (RN)
- RNs in the intensive care units have additional training and speciality in caring for critically ill patients. They provide the patient and family with information about the patient’s health, offer emotional support and work alongside other members of the health-care team to ensure the patient receives the best care.
Nurse practitioner (NP)
- NPs work within the collaborative teams to provide advanced care to patients and families that optimizes patient outcomes and enhances safety, efficiency, effectiveness and accessibility to care. NPs work within a scope of practice that allows them to autonomously diagnose, order and interpret diagnostic tests, prescribe pharmaceuticals and perform procedures and demonstrate the following competencies. The role of the NP is to provide/direct evidenced-based care on individual patients and families, as well as provide clinical leadership and scholarship.
Clinical leader/manager (CLM)
- The CLM is a registered nurse who is responsible for staff and daily activities within a specific intensive care unit.
Clinical nurse specialist
- The clinical nurse specialist is a registered nurse that supports the delivery of quality care to diverse patient populations, and facilitates the development of comprehensive care plans with the interprofessional team to enhance patient safety, outcomes, access to care, and experience.
Clinical nurse educator
- The clinical nurse educator is a registered nurse with additional education and training. They work closely with the interprofessional team to provide support, teaching, and education to new and experienced staff on best practice, quality improvement, research, new devices, and policies changes specific to each unit and across Critical Care.
Intensive care unit patients can have unique and complex nutritional and medical needs. A registered dietitian works with the entire ICU team, to advise and translate the science of nutrition care and intervention into patient specific, evidence-based nutrition care plans. Nutrition support may be provided in different ways: in the form of specialized oral diets, through a feeding tube (enteral nutrition), or by intravenous access (parenteral nutrition).
Occupational therapist (OT)
Occupational therapists are rehabilitation professionals who help patients with their independence and quality of life while they are in the ICUs. They address care aspects like patient positioning in the bed or chair, early cognitive and perceptual assessment, and adapting basic everyday tasks such as feeding and communication.
Occupational therapy assistant (OTA)
The OTA assists the occupational therapist to teach patients how best to get back to their daily activities.
The pharmacist works with the nurses and doctors to manage all of the patients’ medications while in the hospital.
The physiotherapist helps patients move and become mobile early on to prevent weakness and promote independence through a range of motion and strengthening exercises, balance activities in sitting and standing, and gait training. The physiotherapist may use manual techniques to help clear secretions from the lungs as well as teach deep breathing and coughing techniques. Along with the other team members, the physiotherapist helps the patient and family transition to the unit and create a safe discharge plan as appropriate.
Physiotherapist assistant (PTA)
The PTA assists the physiotherapist to develop care plans, administers treatment with the physiotherapist and individually as appropriate, and collaborates with the interdisciplinary team to deliver quality care.
Respiratory therapist (RT)
The respiratory therapist develops plans and treatments to help patients with their breathing. They monitor, evaluate and treat individuals with respiratory and cardio-respiratory disorders. Respiratory therapists have a critical care focus that allows them to be involved in the management of acutely ill patients throughout the hospital.
The social workers provide a wide range of support and services to patients and families across the Critical Care Department. A social worker is available to help support the patient and family during their hospital stay. The social worker can assist with a variety of elements, including financial planning and where to stay while a loved one is in the ICU. Learn more about social work at St. Michael's.
Speech-language pathologist (SLP)
A speech-language pathologist develops plans and treatments for a patient regarding swallowing, speech and other forms of communication.
Spiritual care practitioners provide emotional and spiritual support, as well as assistance with contacting other religious or spiritual groups. They are available to patients and families 24 hours a day, seven days per week.
A clerical assistant is located at the nursing station to answer phones and questions.
Volunteers hold a variety of responsibilities, and can assist or direct questions and concerns from patients and loved ones.
Clinical assistant (CA)
A clinical assistant helps the registered nurse care for the patient, including support with treatments such as bathing and turning.
Unit service workers (USW)
Unit service workers play an integral role in helping to keep all units clean.
Critical Care Response Team (CCRT)
The CCRT is comprised of specially trained Critical Care registered nurses (RNs), registered respiratory therapists (RRTs) and physicians with training and experience in caring for critically ill patients. The team is available to respond to calls from concerned hospital staff (i.e. RNs, RRTs, physicians) to assist in the assessment and treatment of inpatients who meet specific calling criteria.
Patient or family feedback
After discharge from the ICU, we invite patients and family members to take a few minutes to tell us about their experience. The survey below will take approximately three to five minutes to complete and assists our teams in improving the care for patients and families at St. Michael’s Hospital.