Russian Delegation Achieves New Friendships and New Perspectives
A global perspective on critical care is important to understand the past, present and future of patient care worldwide. In May, a delegation of 42 Society of Critical Care Medicine (SCCM) members from ten different countries traveled to Russia for one week to tour hospitals, meet with Russian colleagues and experience the country’s culture. The trip allowed medical professionals from various backgrounds to experience first hand the similarities, differences, common struggles and future goals of critical care. They hailed from Saudi Arabia, Italy, the United Kingdom, Egypt, Belize, Australia, South Africa, Canada, South Korea and the United States.
Click here to view photos from the trip.
Janice Zimmerman, MD, FCCM, and Thomas Rainey, MD, FCCM, led the group through tours of hospitals six hospitals in Moscow, St. Petersburg and Toksovo. The trip included visits to both adult and pediatric intensive care units in urban, suburban and rural settings, as well as teaching and non-teaching facilities; all were government operated. One of the overwhelming lessons from the trip, according to Zimmerman, was the sense that intensive care units (ICUs) throughout the world face similar challenges, but that critical care professionals in every country are dedicated to providing the best care possible. “In many cases, they have all the problems we face, they just have different ways of packaging them -- the specifics are a bit different,” Zimmerman said.
As the Russians offered insight into their critical care practice, the delegation found reoccurring themes and started to build a narrative of Russia’s healthcare history.
According to the hosts, Russia enjoyed a robust healthcare environment until the early 1990s when the system was stalled during the political and social instability that followed the fall of the Soviet Union. However, with growing telemedicine programs, advanced equipment purchases, and well organized physician education programs, critical care once again is moving forward.
About half of the 40,000 intensivist physicians in Russia are trained in anesthesiology and work at the 38 major health centers within the country. While intensivist training in Russia is advanced, the multiprofessional team concept is still developing. The country claims no respiratory therapists, while nurses play a far less independent role in the ICU. Pharmacists, though well trained, have more limited supplies of drugs, typically do not round with the team, and are not very involved clinically. Many of these features are not unlike what you find in many non-academic settings in the United States.
Russia operates specialty hospitals that provide very specific services. In large cities, an “ambulance doctor” triages patients in the field and determines where they should be treated: the cardiac hospital, the pediatric hospital, the neurological hospital, etc. However, Russia has struggled to recruit critical care specialists since the 1980s. As in the United States, workload, lifestyle, and reimbursement were all cited as hurdles in recruiting critical care professionals.
Ample time during each visit was permitted for a robust discussion session, and participants and Russian hosts were able to ask questions and share stories, especially those that highlighted common struggles. For example, many were able to relate to Russia’s problems related to nursing shortages, cultural barriers in the ICU, and staff burnout.
“Exposure to healthcare delivery around the globe was rewarding on several levels,” said Christa Schorr, BSN, CCRN, a nurse from Cooper Hospital University Medical Center in Camden, New Jersey, USA. “Learning innovative methods of healthcare delivery allowed me to understand the potential of doing the best you can with the resources available. Although there were differences discussed related to technology, resources, education and practice methods, there were many similarities related to communication, cross-departmental collaboration and emergency department overcrowding.”
Lasting Relationships
Schorr was one of many delegates who embarked on the trip without knowing anyone in the group. She at least hoped to find a partner to sit with her on the bus, but soon found an entire new group of welcoming, like-minded friends. While much was learned from the various Russian hosts, the delegation members took advantage of a unique opportunity to build lasting professional relationships with SCCM members from around the world.
“It was an extraordinary group of people, many of whom traveled alone, leaving their families for this opportunity,” Schorr said. “Each member had an interesting personal and professional background with a various experiences and talents to share. As the group grew more attached, the trip evolved into a truly meaningful event as we took in the cultural differences, beautiful landscape and unique history of Russia.”
The multiprofessional group of nurses, physicians, respiratory therapists, pharmacists and physician assistants, responded to a call for participants open to all Society members. They hailed from academic, rural and community hospitals; some were active members, but for many it was their first experience being closely involved with an SCCM activity. The unique dynamic created an rich learning environment with fertile ground for conversation and ideas to flourish.
“One of the most important aspects of this trip was the interaction among members of the delegation,” Zimmerman said. “We exchanged ideas with our Russian hosts, but also with each other. Meeting new people and making new friends was the stand-out experience.”
Jorge Hidalgo, MD, a delegate member from Belize, resounded similar feelings about the value of learning from his international colleagues. Not only were they able to learn about different countries’ approaches to critical care, they also were able to create close bonds with critical care specialists from different backgrounds. “Imagine the amazing exchange of ideas of this multiprofessional and international delegation,” he said.
During parts of the trip, the delegation was split into two groups that toured different hospitals. The Society did its best to ensure members were able to visit hospitals related to their interests or specialties. At the end of each day, the delegation regrouped to share their experiences and ideas. To ensure the dialog continues, the Society will host Russian colleagues and delegation participants at a reunion dinner during the 38th Critical Care Congress.
“The Society will continue to reach out and bring together members from around the world,” said SCCM Chief Executive Officer David Martin, who also participated in the trip. “The Society will provide those with an interest in participating in these unique travel experiences an opportunity to interact on the international stage, building relationships and opening dialogs to improve care for critically ill and injured patients worldwide.”
The Society’s excursions to new countries within these unique delegations provides members an opportunity to reach beyond their comfort zones and experience new and different ideas in critical care. Understanding these ideas and sharing patient care information is vital in fulfilling the Society’s mission to provide the Right Care, Right Now.TM
