The relationship between the surgeon and the intensivist in the surgical intensive care unit.
When a patient enters the intensive care unit, the admitting surgeon also enters a new environment. In some hospitals, the surgical intensive care unit (SICU) is "closed"--critical care providers manage care; in others the unit is "open," and the admitting surgeon is in charge. A third system is the "mixed" model of ICU administration; a collaborative approach. This article addresses concerns and conflicts that frequently arise between admitting surgeons and intensivists. It is written from the perspective of two surgeon-intensivists who have been in both roles. Recent behavioral and social research on ICU conflicts and their resolution is reviewed, and and new strategies for conflict resolution are also presented.
Penkoske
Patricia A
PA
Department of Anesthesia, Washington University School of Medicine, 660 South Euclid Street, St. Louis, MO 63108, USA. pattypenkoske@yahoo.com
Buchman
Timothy G
TG
D002985:Clinical Protocols; D003220:Conflict, Psychological; D003422:Critical Care / Q000458:organization & administration*; D034462:Dissent and Disputes; D026690:Ethics, Clinical; D013502:General Surgery; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration*; D007400:Interprofessional Relations / Q000941:ethics; D008505:Medical Staff, Hospital; D017146:Models, Organizational; D012017:Referral and Consultation; D000078329:Workforce