Burnout and poor lifestyle for ICU? what gives

[Alastriss]

Hey all,

I'm a canadian medical student going through the match and I intend to do ICU. I keep reading on these forums that ICU has a terrible lifestyle with high burnout rates, but I'm kind of surprised.

In canada at least, it's considered to be pretty decent for lifestyle, fulltime is I think 18-20 weeks per year, when you work you are working hard, 80-100 hours is typical with various call structures, but then you have about 2 weeks off where some people actually take that time off or work their base specialty. I've worked with a bunch of doctors that stacked 2-3 weeks together and then took 4 weeks off for vacation. Renumeration is about 20-30k per week including procedures and depending on the structure. Note that this is for closed ICU.

So, why are things different in the US?

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[Alastriss]

All these views and no one to offer an opinion? I'm just curious to see what goes on down there and why it's so different.

 

[anradam]

I'm a Canadian as well, staff gastroenterologist and intensivist, which is a pretty rare combo!
As it relates to your question, your right in terms of the time off but a couple of things to keep in mind:
- alot of Canadian ICU docs continue to practice their base specialty (respirology, IM, anesthesia, etc.) so the "time off" is fairly busy
- the mental stress is a lot; if your in community practice you do all the procedures by yourself, in addition to rounding, family meetings. One new sick admit messes up your whole day,it's not like the USA with nurse practitioners etc.
The burnout also comes more from patients and families with unrealistic expectations of what ICU can do. You quickly find out that a large number of the patients you are taking care of should have had care withdrawn along time ago, we've had patients in the ICU for 2 years!! It's not like the USA where these patients get transferred to chronic vent institutions. It gets to you and the nurses after awhile.

 

[Giic]

- the mental stress is a lot; if your in community practice you do all the procedures by yourself, in addition to rounding, family meetings. One new sick admit messes up your whole day,it's not like the USA with nurse practitioners etc.

we've had patients in the ICU for 2 years!! It's not like the USA where these patients get transferred to chronic vent institutions. It gets to you and the nurses after awhile.

Not everywhere in the USA has nurse practitioners... There are a lot of community hospitals where the ICU physician is the only one on staff and does everything from getting the history from patient, to placing the lines, to doing a discharge summary. A lot of places have no residents, no fellows and no nurse practitioners....

Also, there are not always options for chronic vent institutions in all areas... Depending on the town or city, and on the patient's medical conditions, there may or may not be an institution willing to accept them long-term. E.g. I had a patient once who had a trach and also required daily peritoneal dialysis. We could not find an institution to accept her that would do both. The places that accepted trach patients did not offer dialysis, and vice versa....