On the Edge of Life, II: House Officer Struggles Recorded in an Intensive Care Unit Journal

Background: In a general hospital, few clinical settings match the intensity of the intensive care unit (ICU) experience. Clinical rotations in ICUs elicit and emphasize the struggles house officers face on a daily basis throughout their training.

Method: These struggles were recorded by hundreds of residents in a journal maintained in one Medical ICU for the past 20 years. We systematically reviewed these unsolicited entries to develop categories that define and illustrate common stressors.

Results: Stressors for house officers include isolation, insecurity, care for the terminally ill, sleep deprivation, and long work weeks.

Conclusion: By placing the struggles of house staff in context, trainees and their residency training programs can be prepared for the intensity of the experience and for work in clinical practice settings that follows completion of training.