Medical Intensive Care Unit, Hacettepe, University Faculty of Medicine, Ankara, Turkey

The medical intensive care unit (MICU) of Hacettepe University Hospitals was established 25 years ago. It is one of  eight ICUs of the hospital; the others are surgical ICU, anesthesia ICU, cardiovascular ICU, neurological ICU, neurosurgical ICU, pediatric ICU and neonatal ICU. The total bed number in the hospital is 1100 and the total bed number of ICUs is 80, the MICU has 9 beds with 2 isolation rooms. There is also a separate coronary care unit which is considered to be an intermediary care unit where non-invasive monitorization and medical treatment of uncomplicated patients with acute coronary syndromes are followed. Complicated cardiac patients are followed in our unit.

Until 1996, MICU was an open unit with several consultants from different subspecialities following their own patients. In 1996, it was decided that medical ICU should be a subspeciality of department of internal medicine. Then, Dr. Arzu Topeli-Iskit was appointed as the director of ICU, who had training in critical care medicine in the Division of Pulmonary and Critical Care Medicine at Loyola University School of Medicine in Chicago near Prof. Dr. Martin Tobin for two years. Starting from July 1998, Hacettepe University Hospital MICU adopted a closed policy with Dr. Topeli-Iskit as the director. Adopting this policy improved outcome of patients even though more severely ill patients have started to be admitted (for details see Topeli A; Crit Care Med 2005; 33:299).

There is one director (Prof. Dr. Arzu Topeli-Iskit) and 1-3 specialists from departments of internal medicine and pulmonary medicine working in the unit. In addition 4-7 residents from departments of internal medicine, pulmonary medicine, cardiology and emergency department work as staff of the ICU. Nurse to patient ratio is 1 to 3. In addition, there are 2-3 nurse assis­tants per 8 hour shift. Nurse shortage is a national problem in Turkey. We also have physiotherapists and a clinical pharmacist in our staff.