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J Crit Care. 2009 Jun;24(2):243-8. doi: 10.1016/j.jcrc.2008.03.038. Epub 2008 Jul 21.

The intensive care unit work environment: current challenges and recommendations for the future.

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  • 1Faculty of Medicine, Department of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.


The need for critical care services has grown substantially in the last decade in most of the G8 nations. This increasing demand has accentuated an already existing shortage of trained critical care professionals. Recent studies argue that difficulty in recruiting an appropriate workforce relates to a shortage of graduating professionals and unhealthy work environments in which critical care professionals must work.


This narrative review summarizes existing literature and experiences about the key work environment challenges reported within the critical care context and suggests best practices-implemented in hospitals or suggested by professional associations-which can be an initial step in enhancing patient care and professional recruitment and retention in our intensive care units, with particular emphasis on the recruitment and retention of an appropriately trained and satisfied workforce. The experiences are categorized for the physical, emotional, and professional environments. A case study is appended to enhance understanding of the magnitude and some of the proposed remedies of these experiences.

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