December 12, 2022
Complex. Vulnerable. Powerful.
These are a few of the words that have been used to describe the award-winning photo of some members of the Critical Care Trauma Centre (CCTC) team at London Health Sciences Centre.
The LHSC CCTC photo entry, titled “Team Prone,” resonated with those who work in critical care from across the country and was voted to be the face of critical care professionals at the annual Canadian Critical Care Forum (CCCF) that was held November 22 – 24, 2022.
To make a patient “prone” means to move them on to their stomach. In an ICU patient this is a high-risk and important procedure. In the photo, staff are rotating a patient onto their stomach while on a ventilator. The patient is connected to a number of machines, and the teamwork and effort required to successfully complete the rotation without disconnecting the patient from their life support, is extraordinary.
Dr. Robert Arntfield, the critical care physician who took the photo, says, “The vulnerability of the patient hooked up to multiple machines, their life in the hands of the critical care team, the necessary coordination of the team to turn the patient prone, and all while wearing extensive personal protective equipment shows how much effort it takes to save one life. This procedure would be repeated for some patients as many as a dozen times during their stay with us. I have such admiration for our nurses, respiratory therapists and physicians that do this work.”
While all health care professionals had to quickly adapt to the constant changes during the pandemic, the critical care and intensive care units (ICUs) felt this impact acutely.
“When COVID-19 hit it was remarkable at all levels to see the hospital response and how care changed so quickly,” Dr. Arntfield expresses. “In the intensive care and critical care units this was particularly noteworthy as they bore a lot of the load of the system and were required to care for the sickest patients.”
Ines De Campos, Director of the CCTC at LHSC notes, “This picture is the epiphany of critical care during the pandemic. The effort it takes to flip someone over, the effort in getting ready, and the effort of working as a team to be able to do what they do is incredible. The risk is high – for both staff and the patient – and it highlights how everything they do, they do it as a team for patients.”
The CCCF was an emotional meeting of critical care workers where much was discussed around burnout, and exhaustion from the continued burnout. “We acknowledge that it’s tough to be resilient continuously. While this is their job, critical care has had better days. People are sicker, the shortage of critical care nurses is wider, the difference right now is that every day is hard,” De Campos says.
Deborah Wiseman, President, Victoria Hospital at LHSC, shares, “The incredible image depicts the CCTC individuals as the collective team they are. In each situation, they face it as a team, come out of it as a team and prepare for the next event as a team. And while we had our own unique experiences as a critical care team at LHSC, there is, additionally, a shared pandemic experience across the province and country for ICU teams. The photo, and its publication, is an acknowledgement of ‘team’ and that shared experience, here and afar.”
The photo will be published on the Canadian Critical Care Society (CCCS) website, in the December issue of the CCCS newsletter and in the Canadian Journal of Anesthesia which puts LHSC’s CCTC team on the map for the work they are doing. At LHSC, the picture will be framed, engraved and dedicated to the team, and hung in a location defined by the team.
“Independent of COVID-19, there is complexity, cooperation, teamwork and the anonymity of each of the staff in the photo,” Dr. Arntfield explains. “It’s emblematic of the quiet hero role that many of the staff play in driving the success and culture of our ICU. This year, our team is seen across Canada as the face of critical care and I couldn’t be more satisfied and proud.”
