Critical Care Guide

ICU Nursing in
GCC Hospitals

The GCC is one of the world's most intensive critical care employers — higher ratios of ICU beds, advanced technology, and premium salaries for qualified critical care nurses across all 6 countries. Here's everything you need to know before you step into a GCC ICU.

UAE · Saudi · Qatar · Kuwait · Bahrain · Oman CCRN · ACLS · BLS · ECMO · CRRT MICU · SICU · CVICU · NICU · PICU · TICU JCI Accredited Hospitals Tax-Free Salaries
View ICU Salary Tables Certification Guide

ICU Demand Across the GCC

The GCC has invested heavily in critical care infrastructure — creating one of the most concentrated ICU nursing job markets in the world.

40%+
ICU-Class Hospital Beds
GCC hospitals dedicate more than 40% of beds to high-dependency and ICU-level care — among the highest proportions globally, driven by national health investment priorities.
20–35%
ICU Pay Premium
Critical care nurses across GCC countries consistently earn 20–35% more than general ward nurses at the same experience level — due to skill scarcity and high acuity demands.
AED 5K
CCRN Monthly Premium
Holding CCRN (AACN Critical Care) certification adds AED 2,000–5,000 per month to base salary in UAE, with similar premiums across other GCC countries. It is the most recognized ICU credential regionally.
6 Countries
Post-COVID ICU Expansion
All 6 GCC nations dramatically expanded ICU capacity post-COVID-19, adding hundreds of new ICU beds and creating a sustained pipeline of critical care nursing vacancies that remains open today.

Types of ICU in GCC Hospitals

Most large GCC hospitals run multiple specialized ICUs. Understanding each unit's scope will help you target the right role and command the right salary.

MICU
Medical Intensive Care Unit
1:2 Ratio

The most common ICU in GCC hospitals. Manages general medical critical illness — sepsis, respiratory failure, multi-organ dysfunction. High volume and varied complexity, ideal for building broad ICU foundation.

Mechanical ventilation Vasopressors Arterial lines Central venous access Hemodynamic monitoring
Standard ICU premium — excellent entry point
SICU
Surgical Intensive Care Unit
1:2 Ratio

Manages post-operative high-acuity patients following major surgeries — abdominal, thoracic, vascular. Requires understanding of surgical complications, wound management, and anesthesia recovery phases.

Post-op assessment Chest drainage Surgical wounds Epidural management Blood products
+5–10% over MICU in most GCC hospitals
CVICU
Cardiovascular Intensive Care Unit
1:1 Ratio

Cares for post-cardiac surgery and interventional cardiology patients — CABG, valve replacement, TAVI, complex PCI. Requires specific cardiac experience and is the highest-paying ICU specialty in GCC.

IABP monitoring Temporary pacing Cardiac drips PA catheter Chest tube management ECMO (select hospitals)
Highest ICU pay category — cardiac experience required
NICU
Neonatal Intensive Care Unit
1:1–2 Ratio

Cares for premature and critically ill newborns. Entirely separate specialty pathway from adult ICU. GCC hospitals have rapidly expanded NICU capacity with modern incubators and high-frequency oscillators.

Incubator management Neonatal ventilation UAC/UVC lines TPN calculations Family-centered care
Separate pathway — strong demand in GCC maternity hospitals
PICU
Pediatric Intensive Care Unit
1:1–2 Ratio

Manages critically ill children from infancy through adolescence. Distinct from both NICU and adult ICU — requires pediatric medication dosing, weight-based calculations, and different family communication approach.

Weight-based dosing Pediatric ventilation IO access PALS certification Child safeguarding
High demand at pediatric centers — Sidra, KFSH, Al Jalila
TICU
Trauma Intensive Care Unit
1:2 Ratio

Adjacent to emergency and trauma surgery. High-velocity case volume — MVAs, falls, burns, penetrating injuries. Fast-paced environment requiring strong emergency response skills and multi-system trauma assessment.

Trauma assessment ICP monitoring Burns management Damage control Code blue response
High-acuity premium — Hajj surge hospitals value TICU experience

ICU Nurse Salary by Country & Experience

All figures represent gross monthly salary in local currency. All GCC salaries are tax-free. CCRN premium is added on top of base band. Figures reflect market midpoints — top-tier hospitals and recruiter-negotiated packages may exceed these ranges.

Country 0–3 Years Exp 3–7 Years Exp 7+ Years Exp + CCRN Premium
🇦🇪UAE (AED) 8,000 – 12,000 12,000 – 17,000 16,000 – 22,000 +2,000 – 5,000
🇸🇦Saudi Arabia (SAR) 7,500 – 11,000 11,000 – 16,000 15,000 – 21,000 +2,000 – 4,000
🇶🇦Qatar (QAR) 8,000 – 13,000 13,000 – 18,000 17,000 – 24,000 +2,500 – 5,000
🇰🇼Kuwait (KWD) 450 – 700 700 – 1,000 950 – 1,350 +100 – 200
🇧🇭Bahrain (BHD) 600 – 900 850 – 1,200 1,100 – 1,500 +100 – 200
🇴🇲Oman (OMR) 500 – 750 750 – 1,050 1,000 – 1,400 +100 – 200

Data reflects 2024–2025 market intelligence. Packages at premium hospitals (Cleveland Clinic Abu Dhabi, KFSH, Sidra Medicine, HMC) typically exceed midpoints. Housing and transport allowances are additional. Use the Salary Calculator to compare net take-home.

Essential Certifications for GCC ICU Nurses

GCC hospitals — particularly those with JCI accreditation — verify certifications rigorously. These credentials differentiate candidates and directly increase earning power.

🏆
CCRN
AACN — American Association of Critical-Care Nurses

The gold standard ICU certification globally and the most recognized credential in GCC critical care units. Demonstrates expert-level competency in adult critical care. Highly preferred — sometimes required — at top-tier GCC hospitals for senior ICU positions.

Exam Fee
$245 USD
Valid For
3 Years
Eligibility
1,750 hrs critical care in last 2 yrs
Renewal
CERPs or re-exam
Gold Standard — Max Salary Impact
❤️
ACLS
AHA — American Heart Association

Advanced Cardiac Life Support is mandatory in the vast majority of GCC ICUs — it will be requested before your first shift. Covers management of cardiac arrest, acute coronary syndromes, stroke, and post-resuscitation care. Two-day hands-on course with scenario simulation.

Course Length
2 Days
Valid For
2 Years
Cost (approx.)
$150–$300 USD
Where to Get
AHA-authorized centers (some in GCC)
Mandatory — Most GCC ICUs
🫁
BLS
AHA — Basic Life Support

Absolute minimum requirement for any clinical nursing role in GCC. Your BLS card must be current (not expired) before licensing, orientation, or start date. Accepted from AHA, Red Cross, and recognized equivalents. Ensure your card shows the correct provider level (Healthcare Provider).

Course Length
4–6 Hours
Valid For
2 Years
Cost (approx.)
$50–$100 USD
Level Required
Healthcare Provider (HCP)
Absolute Minimum — All GCC Roles
🧠
NIH Stroke Scale
NIHSS — National Institutes of Health

Required for neuro ICU, stroke units, and general ICUs with neurology patient populations. NIHSS certification is obtained through the NIH online program (free). GCC hospitals with neuro ICUs and stroke centers increasingly list this as mandatory in job descriptions.

Cost
Free (NIH online)
Valid For
Varies by hospital policy
How to Obtain
nihstrokescale.org
GCC Recognition
Neuro units, stroke centers
Required for Neuro ICU Positions
🔬
ECMO Training
Extracorporeal Membrane Oxygenation

ECMO competency is one of the fastest-growing premium skills in GCC critical care. Hospitals like Cleveland Clinic Abu Dhabi and Hamad Medical Corporation operate ECMO programs. Training is typically delivered on-site — some hospitals offer it as part of orientation for CVICU/MICU nurses with the right profile.

How to Obtain
On-site hospital training
Salary Impact
Significant premium
GCC Recognition
CVICU, MICU, quaternary centers
External Course
ELSO-affiliated programs
Growing Demand — High Premium
💧
CRRT Competency
Continuous Renal Replacement Therapy

Managing CRRT machines (Prismaflex, Aquarius) is a highly valued ICU skill in GCC. Most hospitals provide in-house training during orientation for competent ICU nurses. CRRT is commonly encountered in MICU and post-transplant ICUs. Proficiency is frequently listed as preferred in GCC ICU job postings.

How to Obtain
In-hospital training program
Salary Impact
Moderate–significant premium
GCC Recognition
MICU, renal, transplant ICUs
External Course
Baxter/Fresenius training programs
In-Hospital Training — Preferred Skill

GCC ICU Standards vs. Your Home Country

What changes — and what stays the same — when you move from your home healthcare system to a GCC ICU. Select your background:

Philippines → GCC ICU

Filipino nurses are among the most sought-after in GCC critical care. Your clinical training from Philippine nursing schools combined with local hospital experience creates a strong foundation — but there are meaningful operational differences to prepare for.

Patient Ratios
PH: 1:3–5 in most ICUs
GCC: 1:1–2 — more time with each patient
Ventilator Technology
PH: Mixed brands, older models in many centers
GCC: Hamilton G5, Maquet Servo-U — expect a tech upgrade
Documentation
PH: Often paper-based or hybrid
GCC: Fully electronic — Cerner, Epic, MEDITECH
MDT Structure
PH: Primarily nurse-physician model
GCC: Full MDT — RT, PT, dietitian, pharmacist on daily rounds
Ward Culture
PH: Relatively flat hierarchy in bedside care
GCC: More formal hierarchy — physicians lead structured rounds
Salary Impact
PH ICU: PHP 25,000–45,000/month
GCC ICU: Equivalent of PHP 120,000–250,000+ (tax-free)
India → GCC ICU

Indian ICU nurses from tertiary centers like Apollo, Fortis, Max, and AIIMS often find GCC ICUs comparable in acuity — but with better staffing ratios, more structured protocols, and significantly higher compensation.

Acuity Level
India: Apollo/AIIMS — high acuity, complex cases
GCC: Similar or slightly lower — better supported
Staffing Ratios
India: Often 1:3–4 in busy centers
GCC: 1:1–2 — dramatically better nurse-to-patient ratio
Protocols & Accreditation
India: NABH accredited hospitals have good protocols
GCC: JCI accreditation — even more structured and audited
Nurse Autonomy
India: High physician intrusion on nursing tasks
GCC: Clearer scope of practice — nurses own more tasks
Documentation
India: Hybrid paper/digital varies widely
GCC: Fully electronic — Cerner/Epic standard
Salary Impact
India ICU: INR 30,000–70,000/month
GCC ICU: Equivalent of INR 200,000–500,000+ (tax-free)
UK → GCC ICU

NMC-registered nurses from the NHS are highly valued in GCC — your evidence-based training and structured critical care competencies translate well. The key adjustments are cultural and contractual, not clinical.

Clinical Standards
UK: NICE guidelines, NHS trust protocols
GCC: Evidence-based — JCI aligns well with NHS quality culture
Salary
UK: Band 5–6 ICU, £28,000–£40,000 taxed
GCC: Higher gross, fully tax-free — significant net advantage
Labour Protections
UK: Union coverage, NMC regulatory protection
GCC: Less union protection — understand your contract carefully
Workplace Culture
UK: Team-oriented, relatively flat NHS culture
GCC: More hierarchical — private sector, more transactional
NMC Competencies
UK: NMC registration and revalidation
GCC: NMC highly valued — recognized by DHA, HAAD, MOH, QCHP
Work-Life Balance
UK: Rostering varies; burnout common
GCC: Structured 12hr shifts; annual leave includes flights home
USA → GCC ICU

American-trained ICU nurses bring some of the strongest clinical foundations globally. The GCC transition is relatively smooth technically — the main differences are around nursing autonomy and compensation structure.

Advanced Practice Roles
USA: NP, CRNA roles common in ICU
GCC: NP/CRNA roles largely absent — physician-led models
Technology
USA: Epic, Cerner, Phillips, Dräger
GCC: Same brands — seamless transition for tech-savvy nurses
Patient Ratios
USA: 1:2 at busy Level I trauma centers
GCC: 1:1–2 — similar to US Magnet hospitals
Salary in USD Terms
USA: $70,000–$120,000+ with state taxes
GCC: Lower gross in USD but 0% tax — net may be similar or better
CCRN Recognition
USA: CCRN is standard credential
GCC: CCRN commands top-of-band salary and fast hiring decisions
Cultural Adjustment
USA: Diverse teams, patient-centric culture
GCC: Highly multicultural — 40+ nationalities on a single ICU floor
Australia → GCC ICU

AHPRA-registered nurses are well-recognized across GCC regulatory bodies. Australia's strong ICU training culture and graduate critical care programs produce highly sought-after candidates — particularly for senior and charge nurse roles.

AHPRA Recognition
AU: AHPRA registration
GCC: Strongly recognized — DHA, MOH, QCHP accept AHPRA easily
ICU Ratios
AU: Strict 1:1 mandated in Level III ICUs
GCC: 1:1–2 — slightly higher at some non-quaternary GCC hospitals
Salary Net Effect
AU: AUD $80,000–$115,000 taxed (~32%)
GCC: Lower gross but tax-free — net broadly comparable or better
Evidence-Based Practice
AU: ACCCN standards, research-informed practice
GCC: JCI-driven — structured audits, care bundles, similar culture
Workforce Culture
AU: Informal, collaborative, flat hierarchy
GCC: Multicultural, more formal — adjust communication style
Career Opportunity
AU: Strong career ladder within hospitals
GCC: Faster promotion possible — leadership roles available
Southeast Asia, Africa & Other Countries → GCC ICU

Nurses from rapidly developing healthcare systems in Southeast Asia, Sub-Saharan Africa, and other regions often experience the most significant technology and protocol upgrade when joining GCC ICUs. Excellent orientation programs at top hospitals smooth this transition.

Technology Upgrade
Home: Mixed or older equipment
GCC: State-of-the-art — plan for a significant learning curve on new equipment
Orientation Programs
Home: Variable, often brief
GCC top hospitals: 6–12 week structured ICU orientation with preceptorship
Protocols
Home: Varies — often informal or evolving
GCC: Fully protocolized — VAP bundle, CLABSI bundle, sepsis pathway
Support Networks
Home: Familiar cultural context
GCC: Strong national communities — Filipino, Indian, African nurse groups active
Salary Step-Change
Home: Often low purchasing power
GCC: Transformational — remittance impact significant for family
Documentation
Home: Often paper-based
GCC: Electronic — invest time pre-arrival learning Cerner or Epic basics

A Day in the Life of a GCC ICU Nurse

A typical 12-hour day shift in a GCC ICU — based on common practice at JCI-accredited hospitals across UAE, Qatar, and Saudi Arabia.

07:00
Shift Handover — SBAR Report
30–45 minute bedside handover from night shift nurse. Structured SBAR format — Situation, Background, Assessment, Recommendation. Review current drips, ventilator settings, latest labs, IV access, and outstanding tasks. Critical moment — ask about anything unclear.
07:45
Head-to-Toe Assessment & Monitor Review
Systematic head-to-toe physical assessment. Review all monitored parameters — HR, rhythm, BP, MAP, SpO2, ETCO2 if applicable, ICP if neuro patient. Verify ventilator settings match orders. Assess IV lines, drains, catheter, skin integrity, pain/sedation scores.
08:30
Morning Medications & Care Bundle Checks
Administer scheduled medications with 5 rights verification via barcode scanning. Complete care bundle documentation — VAP bundle (HOB 30–45°, daily sedation vacation, oral care), CLABSI bundle (line assessment, dressing integrity), DVT prophylaxis, pressure injury prevention.
10:00
Physician Ward Round — Documentation
Accompany the intensivist and MDT on structured ward rounds. Present your patient's overnight events and current status. Document all orders in real time — medication changes, ventilator wean trials, fluid management decisions, consult requests. Clarify orders before the team leaves the bedside.
11:00
Patient Care — Repositioning, Hygiene, Wound Care
Complete patient hygiene (bedbath), oral care, eye care. Reposition every 2 hours — document in care plan. Assess and dress wounds. For intubated patients: secure ETT, verify tube position and depth. For CVICU patients: assess sternal or graft wounds. Liaise with physiotherapy for early mobilization.
12:30
Charting, Reassessment & Fluid Balance
Update nursing flowsheet with all vitals, assessments, interventions. Calculate fluid balance to date — compare inputs vs outputs. Flag significant positive or negative balance to the team. Document GCS, pupil response, pain and sedation scores (RASS, CPOT). Review pending lab results.
14:00
Procedures — Central Lines, Blood Draws, Fluid Adjustments
Assist with or perform procedures per scope: blood sampling from arterial line, CRRT circuit assessment, central line access, medication infusions adjustment per titration protocols. Respond to any acute deterioration with rapid assessment and escalation. Prepare for any incoming procedures from the OR or IR.
16:00
Family Visiting Hours — Communication
16:00
Family Visiting Hours — Communication
Most GCC ICUs have structured visiting windows (typically 2–3 hr/day). Communicate patient status to family in an empathetic, clear manner. Use medical interpreters where needed — multilingual families are common. Document family education and conversations. Manage distressed family members with de-escalation techniques.
17:30
Evening Medications & Reassessment
Administer scheduled evening medications. Reassess head-to-toe — compare to morning baseline. Document any changes in neurological status, hemodynamics, respiratory mechanics. Adjust positioning, ensure comfort and pain control. Alert on-call physician for any concerning trends early — don't wait until handover.
18:30
Handover Preparation — Documentation Review
Complete all outstanding nursing documentation. Verify fluid balance, medication administration record, care bundle compliance. Write nursing notes covering shift summary — events, interventions, patient response, outstanding concerns. Prepare a structured SBAR handover for night shift. Ensure room is tidy and equipment is functioning.
19:00
Handover to Night Shift
Bedside SBAR handover to incoming nurse. Walk through patient status, active problems, ongoing drips and settings, tasks completed and outstanding, family concerns, and any anticipated overnight events. Sign off in the EMR. Exit after night nurse confirms they are comfortable with patient status.

Top GCC Hospitals for ICU Nurses

These hospitals represent the best combination of salary, training quality, technology, and career development for critical care nurses across the GCC.

🇦🇪
Cleveland Clinic Abu Dhabi
Abu Dhabi, United Arab Emirates

World-class CVICU and MICU running American protocols. Joint venture with Cleveland Clinic Ohio — same clinical standards, pathways, and quality metrics. Direct international recruitment with American-standard orientation. Home to ECMO program and advanced heart failure care.

🇸🇦
King Faisal Specialist Hospital
Riyadh, Saudi Arabia

Saudi Arabia's premier quaternary referral center. Runs organ transplant ICUs (liver, kidney, heart), BMT, and complex oncology critical care. Research-active environment with academic nursing pathways. One of the most clinically complex ICU environments in the GCC.

🇶🇦
Hamad Medical Corporation
Doha, Qatar

The largest integrated healthcare system in Qatar and one of the GCC's most comprehensive ICU networks. Operates MICU, SICU, TICU, and specialty ICUs across multiple hospitals. Strong training programs, government employer stability, and JCI accreditation throughout.

🇶🇦
Sidra Medicine
Doha, Qatar

Brand new quaternary academic medical center — purpose-built, fully digital, with state-of-the-art pediatric and NICU facilities recognized as a regional center of excellence. Epic EHR throughout. Research-active and expanding rapidly. Ideal for NICU/PICU specialists seeking cutting-edge environment.

🇸🇦
King Abdullah Medical City
Mecca, Saudi Arabia

One of Saudi Arabia's largest hospital complexes, with major SICU and MICU capacity. Unique annual challenge: Hajj season surge with mass-casualty capacity activation. Provides extraordinary experience in large-scale critical care operations and disaster medicine preparedness.

🇰🇼
Al Sabah Hospital
Kuwait City, Kuwait

Kuwait's primary national referral center for complex cases. Well-staffed ICU with government employer stability and a strong collegial nursing culture. Good entry point into Kuwaiti healthcare for nurses seeking government-sector experience with structured working hours.

🇧🇭
King Hamad University Hospital
Muharraq, Bahrain

JCI-accredited academic medical center with a research-oriented ICU culture. Smaller than GCC giants but offers excellent training quality, manageable workloads, and an academic atmosphere conducive to professional development. Good option for nurses pursuing postgraduate education alongside clinical work.

🇴🇲
Sultan Qaboos University Hospital
Muscat, Oman

Oman's premier academic medical center — affiliated with Sultan Qaboos University. Offers a genuine academic-clinical balance for nurses interested in research and teaching. Competitive salary for Oman, stable government employer, and a supportive environment for career progression and CPD activities.

ICU Skills Checklist

Check the skills you're competent in. Advanced skills will highlight with a premium indicator — use this to assess your salary positioning and identify gaps to address before applying.

0
Basic Skills Checked
0
Advanced Skills Checked
0
Total Skills
Select your skills above to see your GCC ICU readiness assessment.
Essential Skills (Must Have)
Mechanical ventilator management
Hemodynamic monitoring (MAP, CVP, CO)
VAP bundle implementation
PICC and central line care
Arterial line management and sampling
Continuous cardiac monitoring interpretation
12-lead ECG acquisition and recognition
IV medication infusion calculations
Code blue / resuscitation response
Advanced Skills (Premium Pay)
IABP (intra-aortic balloon pump) monitoring +premium
ECMO assist and circuit management +premium
CRRT (Prismaflex / Aquarius) management +premium
Advanced vasoactive drip titration +premium
Pulmonary artery catheter (Swan-Ganz) +premium
Bronchoscopy assist and airway support +premium
ICP monitoring and neuro-critical care +premium

ICU Nursing in GCC — FAQ

Answers to the most common questions from nurses considering GCC critical care positions.

For most GCC ICU positions: yes, prior ICU experience is required. The vast majority of hospital job postings specify a minimum of 2 years ICU experience. Some hospitals (particularly newer or expanding ones in Saudi Arabia and Qatar) do accept experienced general ward nurses with strong clinical backgrounds into structured ICU transition programs — but this is the exception, not the rule.

If you are transitioning from a general ward, your best approach is to: (1) request a transfer to a step-down or high-dependency unit in your current hospital, (2) complete ACLS and begin CCRN study, and (3) target hospitals in Oman or Bahrain, which have slightly more flexible hiring criteria for motivated candidates with strong clinical skills.
The core clinical skills are universal — critical illness is critical illness. The key differences you will encounter in GCC ICUs are:

Technology: State-of-the-art equipment (Hamilton/Maquet ventilators, Philips/GE monitoring, Cerner/Epic EMR) — expect a learning curve if coming from lower-resourced environments.

Staffing: Better ratios (1:1–2) than most non-Western healthcare systems, giving you more time for thorough patient care.

Protocols: Rigorous, JCI-driven care bundles — VAP, CLABSI, CAUTI bundles are audited and taken seriously.

Culture: Highly multicultural teams. More formal physician-nurse hierarchy than Anglophone systems. Documentation expectations are intensive.

Autonomy: Generally more physician-directed than Australia/UK/USA — nurses do not typically have prescriptive authority.
Yes — ICU nursing operates 24/7 by definition, so night shifts are a standard part of your roster. Most GCC hospitals rotate day and night shifts on a pattern basis (e.g., 2 weeks days / 2 weeks nights, or rotating weekly).

Night shift allowances vary by hospital and country:
— UAE private hospitals: typically 10–25% night shift premium on top of base.
— Saudi MOH hospitals: structured night allowances per government pay scale.
— Qatar (HMC): additional shift allowance for unsociable hours.

Some hospitals include night shift allowances as a blended base salary rather than a separate line — clarify this during contract negotiation. Fixed-shift positions (permanent nights or permanent days) exist at some hospitals and may command a premium or preference depending on the candidate's situation.
Technically yes — but it is difficult and takes time. Most GCC hospitals have internal transfer policies that require a minimum of 1–2 years in your current unit before requesting a transfer. ICU positions are competitive internally because of the salary premium.

The more realistic pathway is: (1) If you arrive on a general ward, excel in your current role. (2) Complete ACLS and document your interest in critical care with your nurse manager. (3) Request rotations or assignments to high-dependency/step-down units. (4) After 12–18 months and with a strong performance record, apply for an internal ICU vacancy.

A faster route: some nurses return to their home country to gain 1–2 years ICU experience, then re-apply to GCC directly for an ICU position. This almost always results in a significantly higher starting salary than the internal transfer route.
GCC ICU staffing ratios are generally good by international standards — particularly at JCI-accredited hospitals:

Standard ICU (MICU, SICU, TICU): 1 nurse to 2 patients (1:2) — the international ICU benchmark and consistently applied at top GCC hospitals.

High-acuity ICU (CVICU, post-cardiac surgery, ECMO patients): 1:1 — one nurse per patient for the most critical patients.

NICU/PICU: 1:1 to 1:2 depending on acuity and infant/child weight category.

Step-down / HDU: Typically 1:3, bridging ICU and general ward.

Ratios may temporarily worsen during surge periods (Hajj season in Saudi Arabia, mass casualty events) — hospitals have surge protocols for these situations. In general, GCC ICU ratios are significantly better than what nurses experience in the Philippines, India, and many African countries.