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Passion and compassion in Critical Care

If you ever have the pleasure of meeting Marina Bitton, Clinical Team Manager (CTM) in North York General Hospital's Critical Care Unit, right away you will notice her impressive, calm demeanor. She possesses a calm energy that is not only welcoming but also an asset in what is often a high-stress environment.

“I found my passion in the health care sector working as a medic early in my career, especially when it involved responses with immediate interventions for life or death situations,” recalls Marina. “I loved it so much that I spent most of my career in critical care in different capacities, including as a bedside nurse and educator.”

Marina has been an important member of the hospital's team for 25 years. As the Clinical Team Manager of the Critical Care Unit since 2013, Marina ensures the unit is running optimally.

The 21-bed Level3 Critical Care Unit* at North York General is a combined intensive care unit and coronary care unit that cares for patients requiring mechanical ventilation, intensive monitoring or acute dialysis.

Offering
comfort and support to patients and families

Loss of life is something staff face daily on this unit. They are intimately involved in the lives of patients and families — often at their worst moments when someone is passing away, or their best moments when things go well and they see their patient discharged.

“When a loved one is admitted to the Critical Care Unit their families are naturally very stressed, scared, anxious and fearful,” says Marina. “We understand this; in addition to providing exceptional care we try hard to look for ways to support a family's unique needs if possible.”
 
Making a family's dream come true

Marina recountsthe difficult story of a young woman with a rare disorder who was admitted to the Critical Care Unit. Her condition was deteriorating and the family could see that their “little girl” was slipping away. Yet the family had a dream that their daughter, whom they had cared for at home since birth, could be a bridesmaid at her sister's wedding.

“This young lady required a special mattress on the floor where she was most comfortable, so we nursed her on the floor,” remembers Marina. “Her disorder was so rare; we worked diligently and partnered closely with her parents to provide the best care possible. They taught us and we taught them.”

Physicians, nurses and other allied health care specialists worked with this patient and her family, trying to make her as well as they could so she might participate in her sister's wedding. Together, they made this hope a reality. The young woman was discharged from critical care to attend her sister's wedding, created lasting memories. She passed away some weeks later in her own home.

“Her parents were so appreciative and expressed such gratitude. It touched our hearts to hear how kindly her mother spoke about us as a unit at a Town Hall Meeting where all the critical care units from different hospitals meet once a year,” says Marina.

The Critical Care Unit was one of the first units at North York General to implement patient- and family-centred care almost six years ago. Family engagement has improved significantly during this time as family members are now encouraged to attend rounds, ask questions and visit their loved one at any time because of open visiting hours.

I work with a phenomenal team
Marina Bitton, Clinical Team Manager of the Critical Care Unit, (far right) with some members of her team.
Marina Bitton, Clinical Team Manager of the Critical Care Unit, (far right) with members of her team.

Working with patients who have severe and life-threatening illnesses and injuries requires specialty training. Our physicians are specialized in intensive care medicine and our interdisciplinary team members all have specialty training related to their profession, in combination with critical care. In addition to technical skills, the team relies on their emotional intelligence.

“We draw on all of these skills when we think on our feet, make minute-by-minute decisions as a patient's condition fluctuates, manage under pressure, and work as individuals but also within a team,” says Marina. “There are situations where you need all hands on deck, and there will be five or six health care professionals in the room giving their best to save a life.”

The Critical Care team is comprised of 140 people — doctors, nurses, respiratory therapists, an educator, a unit coordinator, social workers, physical therapists, dietitians, pharmacists, unit secretaries and team attendants.

“We try to take ‘aside moments' as a team,” says Marina. “For example, when we experience an emergency code and then a death on the unit, our team comes together for a debrief — this is an opportunity to support each other, answer questions and to see if people are doing ok. It's hard not to take this work home with you. One of the ways we thrive and maintain our passion for the profession is by supporting each other in difficult moments.”

My family rejuvenates me

When the work day has been especially challenging, Marina looks forward to spending time with her family and friends. They are a source of joy for her and lift her spirits. Sometimes, she also lets herself escape in a good book or movie.

“Depending on my mood, I may feel like a comedy, or a drama. Sometimes I want to cry or laugh, it all depends on what's going on that day.”

Despite daily challenges, the vision for the future of the Critical Care Unit is strong. “We continue to implement best practices, evolving technology, and quality initiatives,” Marina says. “I love this hospital for many reasons: the people, culture, and our focus on quality of care for patients and families make this a special place to work — you can't find that everywhere.”

Learn more about the Critical Care Unit.
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* According to the Critical Care Services Ontario website, Level 3 units are capable of providing the highest level of service to meet the needs of patients who require advanced or prolonged respiratory support — including invasive ventilator support — or basic respiratory support together with the support of more than one organ system.

December 6, 2017
 
This article first appeared in the December 2017-January 2018 issue of The Pulse, North York General Hospital's community newsletter. Subscribe to receive 10 issues per year.

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