Philosophy of Care!

It is not unusual for our Paediatric Intensive Care Unit to receive patients from all over the UK, we are a centre for some highly specialised cardiac surgery, but we have just had a patient flown down to us with a relatively common cardiac condition called 'Transposition of the Great Arteries'; this tells us that (as at today's date) there are few childrens' intensive care beds available nationwide. There are other PICUs which were a lot closer! Certainly our unit has been horrendously busy in recent weeks and I'm sure we are not alone.

When I first started working in PICU, nearly two decades ago, I recall having a conversation with one of our consultant intensivists during which I suggested that a referal we had received could not be accepted because our unit was at capacity. He replied, "Peter, there isn't a 'St Elsewhere' for this kid!"

Up until that moment in time I had had the naive notion that the state would always provide. If we couldn't take this child then another unit somewhere else would. I had a vision of an all wise, monolithic system that planned and made provision for all eventualities. How wrong I was. No "system" works, not really.

In so far as any system functions; it is down to the good will of individual people. If individuals have a 'jobs-worth' approach to their work then no system will serve its intended purpose. I recall this same consultant having to battle the system to get our "Retrieval" service up and running; we had to start on a shoestring budget and prove that it served a purpose.

At the "Saline Nerve Child Hospital" our philosophy is always to try and make room for any child who needs intensive care - we will be loathe ever to say that "we have no beds" when the 'Emergency Bed Service' phones to ask what our 'bed state' is. We will bend over backwards to find a way of creating a bed for a child who needs PICU - it's a philosophy of care I feel comfortable with.