What We Do

The Medical Surgical Intensive Care Unit at Toronto General is a 24-bed, level 3 closed critical care unit providing care to approximately 1000 patients annually. Our patients require advanced ventilation, technological and hemodynamic support to overcome the complex challenges of transplantation, complex medical and surgical conditions, shock syndrome, and multisystem organ failure.

A highly skilled inter-professional team provides leading-edge care to patients with:

  • Solid organ transplantation
  • Cardiopulmonary failure
  • Adult respiratory distress syndrome (ARDS)
  • Sepsis
  • Multi-organ dysfunction
  • Pulmonary hypertension
  • Pulmonary thrombosis
  • Shock syndrome(s)
  • Renal failure
  • Advanced medical conditions & co-morbidities
  • Post-op complicated surgical cases

You need to be seen, assessed and/or referred by the Intensivist or Critical Care Response Team to become a patient in MSICU.

What Makes Us Special

  1. Our Experience:
    MSICU offers innovative, leading-edge treatment modalities not readily accessible in any other part of the city and province. We offer services to patients from other provinces that would otherwise not have these treatments available. We have an excellent multidisciplinary team that works together to provide excellent patient and family-centred care. MSICU at TGH is one of the busiest intensive care units in Canada.
  2. Our Research
    Our ICU intensivists are actively involved in local, national, international and multi-centred research, which currently has and will continue to have a significant impact on the lives and outcomes of our patient population.
  3. Our Education
    Education is ongoing and current, being the highest standard of care and practice in Canada.

 Materials and Resources to Help You

Patient & Families Services

You can also find other services throughout UHN. Learn more about patient and family services available throughout UHN.​​

Resources from the Patient & Family Education Program PDF Icon

* These material(s) are also available in other languages.

 Your Inpatient Stay

The Intensive Care Unit can be a frightening experience. There are different types of equipment, machines, and alarms going off. You will be hooked up to monitors, equipment and administered medications.

The nursing-staff-to-patient ratio is 1:1. We have a lot of support staff and consulting teams that will be involved in patient care.

Our patients have varying illnesses and treatment requirements, and they respond differently to treatment. There may be good days and bad days with various lengths of hospital stay. Your condition may fluctuate, so it is important to take it one day at a time.

When You Arrive

Patients are admitted either directly from surgery, the general ward, or emergently after consultation with the Critical Care Response Team. Upon your arrival, the ICU team will need time to settle you and get treatment started. There will be times when family members will be asked to wait outside in the waiting room while procedures are being completed.

During Your Stay

Your Treatment

There are many different reasons why patients are admitted to the MSICU. Treatment and care varies between patients. Medical-Surgical staff will update you on your progress daily. Family meetings are available upon request. Most of our patients are on different life support modalities, such as ventilators, intravenous drips/medications, and dialysis.

Monitoring Your Health
Your healthcare team will see you every day. We will talk with you about how you are doing and answer any questions you may have. If you want to speak with a member of your healthcare team at any other time, ask the nurse looking after you.

You may have blood tests, x-rays, ultrasounds, CT scans or other tests performed during your stay. If we recommend that you receive any of these tests, we will discuss them with you in advance, and we will meet with you afterward to discuss the results.


We encourage you to have family members, friends and other supportive visitors during your stay. You are welcome to meet with visitors in your room, in the common lounge areas and in the visiting areas outdoors.

UHN hospitals offer flexible visiting hours. Learn more about visiting patients at UHN »


Throughout our hospital, you and your family and other visitors can find a range of amenities to make your stay more enjoyable and comfortable. Learn more about amenities at UHN hospitals.

Eating and Drinking

We have a dedicated dietician in the MSICU who will follow your condition and assess when and if you are able to be fed. This is re-assessed on a daily basis.

You will have a chance to tell us about your food preferences and allergies when you are admitted to the hospital. This information will be entered into our computer system, and your meals will be provided with your preferences and allergies, as well as the diet plan specified by your doctor taken into account.

Family members are not allowed to bring any food or drinks to the bedside or into the MSICU.


If you are taking any medications before you enter the hospital and when you are admitted to the MSICU, our Medical Team and Pharmacists will reconcile all home medications as soon as possible. All new medications ordered and new medications prescribed during your stay will be determined and assessed during daily rounds with the medical team and a pharmacist.

We determine patient allergies before any medications are administered.

If you want to know more about your medications, you can ask your pharmacist, doctor or nurse at any time.

Pain Management

UHN has an Acute Pain Service, which will be involved in your care if needed. We will ensure your pain is managed.

As your body heals, you may experience some or a lot of pain and discomfort without being able to express your pain. Our goal is to make sure that you have as little pain as possible or are pain-free.

Most of our MSICU patients are not able to express pain symptoms themselves. The health care team will be managing and assessing your pain daily to ensure a pain-free experience, which will:

  • Decrease the amount of stress on your body
  • Promote healing
  • Decrease complications
  • Prevent the development of chronic or long-term pain

We use a special MSICU pain tool to manage your pain if you are unable to verbally state or point to the painful area.

Hand Washing

It is important to wash your hands well and often while you are in the hospital. Washing your hands will reduce the chances that you will become sick or get an infection.

It's okay to ask your doctor, nurse and other healthcare providers to wash or sanitize their hands using a gel hand sanitizer before examining you.

You can learn more about infection control at UHN.

For Families

Our goal is to work with you to provide the best possible care for your loved one. We know that having a seriously ill friend or family member is very stressful. We will do our best to provide support. By working together as a team, we can help you and your loved one cope with this stressful situation.

Our Visiting Policy in the ICU

  • We welcome visits from family and friends. Visits help the healing process of our patients.
  • Don't visit if you are feeling sick, have a cough or fever, have vomiting or diarrhea.
  • Call the Critical Care Unit before entering the unit. Please use the intercoms.
  • Try to have only 2 visitors come at a time. In special cases, we may allow more.
  • Make sure children under the age of 12 have permission to visit from the bedside nurse. They must be with an adult at all times.
  • Please wash your hands or use hand sanitizer before entering and leaving the ICU and your loved one's room.
  • Do not bring fresh flowers, food or latex products into the ICU.
  • Remember to leave your valuables at home so they don't get lost or stolen.

Choosing a Spokesperson

Please ask one person to be the main contact with the health care team. This person will receive updates from the team and pass the information on to family or friends.

Choosing a spokesperson reduces confusion, protects patient privacy and lets the health care team focus on what's most important - caring for your loved one. Please provide us with the name and contact number of this person.

Being Present at Rounds

Every day, the health care team talks about how your loved one is doing and how to continue their care. These meetings are called rounds. If the patient gives their consent (agrees), we welcome the family to attend rounds.

During rounds, you have a chance to:

  • Share important information with the team
  • Hear a quick update about your loved one's condition
  • And have a chance to ask questions

If you are the Power of Attorney or legal decision maker for the patient's health-related decisions, please speak to the bedside nurse if you want to take part in rounds. They can guide you through the process.

Patient confidentiality (privacy) is very important to us. Help us by keeping all information about your loved one and other patients private.

Attending Family Meetings

Sometimes, we need to speak to you and other family members in more detail about your loved one's care. In this case, we will arrange a family meeting. These meetings give you a chance to meet many of the team members and talk about your loved one's progress. We will work with you to schedule the meeting at a convenient time for everyone.

Helping with Daily Care

Friends and family are a very important part of the care of patients. Please speak to a member of the healthcare team about how you can help care for your loved one.

Some examples of how you can help include:

  • helping to bathe them
  • combing their hair
  • brushing their teeth
  • helping them with leg and arm exercises
  • talking with them

We can also teach you some ways to communicate with your loved one in case they are unable to talk. This is a very important and easy skill to learn.

You are an important part of your loved one's health care team, so you need to take care of yourself. Even though this is a stressful time, try to eat and sleep properly. Taking breaks away from the hospital is very important.

Remember: Your loved one will never be alone in the ICU.

How Long Will Your Stay Be?

There are various lengths of stay depending on the patient's needs and progress.

The length of your stay will be based on your healthcare team's assessment of your condition. Soon after you arrive on the unit, we will discuss with you and your family how long you will be staying.

Preparing for Your Discharge

You will leave MSICU when stable and will be discharged either to an acute care unit or general ward.

We will work with you and your family to start planning early for your discharge to help you with a safe and successful transition.

At the end of your stay, we will give you discharge instructions and a prescription for any medications you require.

If you have any questions about your discharge or your care needs before you leave the hospital, don't be afraid to ask a member of your team. We are here to help you.​

 Meet Our Team

Medical Director: Dr. Niall Ferguson

Nurse Manager: Denise Morris

Advanced Practice Nurse Educator: Klara Malkova

Patient Care Coordinators: Ingrid Daley, Tyler Glass, Diana Heng

Senior Professional Practice Leader: Elizabeth Gordon

Senior Clinical Director: Linda Flockhart

Director, Professional Practice: Leanna Graham

Inter-professional Team Members:

  • Physiotherapists: Vincent Lo and Nathalie Cote
  • Speech Language Therapists: Trish Williams
  • Occupational Therapist: Alexis Seaman
  • Pharmacists: Brenda Kisic and Paula Brown
  • Social Worker: Gail Fairley
  • Spiritual Care: Derek Strachan


Charge Nurse
Charge nurses help with the flow of patients and assist the bedside nurses throughout the day. They also work closely with the PCCs to guide decisions affecting the care of the patient and the unit 24 hours a day.

ICU Registered Nurses (RN)
This is a nurse with special critical care training who will assist in the care of your loved one 24 hours a day while in the ICU.

Nursing Students
UHN is a teaching hospital. All nursing students in the unit get close supervision from ICU Facilitators and nursing staff. Students will be identifiable by their name tags.

Nurse Manager
Nurse Managers are in charge of the unit and may be contacted by patients and their families, about any concerns not addressed by the bedside nurse or medical team.

Patient Care Coordinator (PCC)
The PCC acts as a resource for the inter-professional team and nurse manager. PCC is a key leadership position. PCC acts as a mentor to provide direction, development and preceptorship to the nursing team. The PCC can also be contacted with any concerns if the nurse manager is unavailable or cannot be addressed by the bedside nurse or medical team. PCCs are available 24 hours a day in critical care.

Medical students, residents and fellows also may be part of our team. Learn more about health care professional trainees at UHN.

Inter-professional Team Members Roles

Registered Dietitians
MSICU has a dedicated dietician who will ensure a patient's nutritional needs are met throughout their ICU stay.

Occupational Therapists
MSICU has one dedicated Occupational therapist who provides care to ensure a patient's rehabilitation needs are met while in the ICU. In the ICU, occupational therapists provide splints that prevent muscle tightening and maintain proper positioning of hands and feet.

MSICU has two full-time and 1-part-time dedicated pharmacists who work with the inter-professional team to ensure the proper medications are ordered and managed during a patient's critical care stay.

MSICU has two dedicated physiotherapists who work with patients to provide rehabilitation care to maintain and improve strength in the limbs and to assist in keeping the lungs clear while in critical care.

Respiratory Therapists (RT)
The respiratory therapist is responsible for the "breathing machine" (ventilator) and will assess and manage a patient's breathing status daily while admitted. Respiratory Therapists work closely with the inter-professional team to ensure a patient's breathing needs are managed throughout their critical care stay.

Social Workers
MSICU has one dedicated Social worker who provides family counseling, assistance and support for patients and their loved ones. Our social worker also coordinates family meetings with the medical team regularly to update the family on a patient's progress and care.

Spiritual Care Professionals
MSICU has one dedicated spiritual care professional who will provide support for patients and their family during their stay. Spiritual care professionals work with all faiths.

Support Services

Patient Care Assistants (PCA)
Patient care assistants work with the nursing staff and assist with the care of patients, such as bathing, feeding, turning and mobility. MSICU has 24-hour PCA coverage.

Volunteers manage the waiting area and help to organize visits to the MSICU. They direct your family to other areas and services within the hospital.

Ward Clerk
MSICU has 24-hour ward clerk coverage who provide administrative support and are typically the first person loved ones will contact with when they call or visit the MSICU.

Learn more about health care professional trainees at UHN.​

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