CRITICAL CARE NURSING

INTODUCTION: OVERVIEW OF THE SYSTEM

Critical care nursing is the

field of nursing with a focus on
the utmost care of the
critically ill or unstable
patients following extensive
injury, surgery or life
threatening diseases. Critical
care nurses can be found
working in a wide variety of
environments and specialties,
such as general intensive care
units, medical intensive care
units, surgical intensive care units, trauma intensive care units, coronary care units,
cardiothoracic intensive care units, burns unit, pediatrics and some trauma center emergency
departments. The aims of Intensive and Critical Care Nursing are to promote excellence of care
of critically ill patients by specialist nurses and their professional colleagues; to provide an
international and interdisciplinary forum for the publication, dissemination and exchange of
research findings, experience and ideas; to develop and enhance the knowledge, skills,
attitudes and creative thinking essential to good critical care nursing practice.

Critical care nurses are also known as ICU nurses, treat patients who are
chronically ill or at risk for deadly illnesses. They apply their specialized knowledge base to care
for and maintain the life support of critically ill patients who are often on the verge of death.
On a day-to-day basis a critical care nurse will commonly, "perform assessments of critical
conditions, give intensive therapy and intervention, advocate for their patients, and
operate/maintain life support systems which include mechanical ventilation via endotracheal,
tracheal, or nasotracheal intubation, and titration of continuous vasoactive intravenous
medications in order to maintain a " mean arterial pressure that ensures adequate organ and
tissue perfusion.

Critical-care nursing is that specialty within nursing that deals specifically with
human responses to life-threatening problems. A critical-care nurse is a licensed professional
nurse who is responsible for ensuring that all critically ill patients and their families receive
optimal care.

Although very sick and complex

patients have always existed, the
concept of critical care is relatively
modern. As advances have been made in
medicine and technology, patient care
has become much more complex. To
provide appropriate care, nurses needed
specialized knowledge and skills, while
care delivery mechanisms also needed
to evolve to support patients needs for
continuous monitoring and treatment.
The first intensive care units emerged in
the 1950s as a means to provide care to very sick patients who needed one-to-one care from a
nurse. It was from this environment that the specialty of critical-care nursing emerged.

According to the March 1996 report, The Registered Nurse Population, by

the U.S. Department of Health and Human Services (DHHS), there are 273,850 nurses in the
U.S. who care for critically ill patients in the hospital setting. Critical-care nurses account for an
estimated 24 percent of the total number of nurses working in the hospital setting.

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FEATURES OF CRITICAL CARE

Critical care nursing is a complex and challenging nurse specialty to which many
registered nurses (RNs) aspire. Also known as ICU nurses, critical care nurses use their advanced
skills to care for patients who are critically ill and at high risk for life-threatening health
problems.

The Critical-care nurses work in a wide variety of settings, filling a variety of roles.
They are bedside clinicians, nurse educators, nurse researchers, nurse managers, clinical nurse
specialists, and nurse practitioners. With the onset of managed care and the resulting
migration of patients to alternative settings, critical-care nurses are now called upon to care for
sicker patients more than ever before.

Managed care has also fueled a growing demand for advanced practice nurses
in the acute- and critical-care setting. Advanced practice nurses have received advanced
education at the masters or doctoral level. In the critical-care setting, they are most frequently
Clinical Nurse Specialists (CNS) and Acute-Care Nurse Practitioners (ACNPs). They
demonstrate a high level of independence and in many states, they are now eligible for direct
financial reimbursement, just like physicians.

A CNS is an
expert clinician in a particular
specialtycritical care in this
case. The CNS is responsible for
the identification and
intervention of clinical problems
and in the management of those
problems to improve care for
patients and families. They
provide direct patient care,
including assessing, diagnosing,
planning and prescribing
pharmacologic and non-
pharmacologic treatment of health problems. ACNPs, in the critical-care setting, focus on
making clinical decisions related to complex patient care problems encountered in the acute-
care setting. Their activities include health history and risk appraisal, interpretation of
diagnostic tests and providing treatment, which may include prescribing medication.

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Specialties: Critical-care nursing includes the sub-specialties of adult, pediatric, and neonatal
nursing practice.

Practice Settings: According to the March 1996 DHHS report, 60 percent of all nurses work in
the hospital setting. Within the hospital setting, critical-care nurses are found wherever there
are critically ill patients: intensive-care units (ICUs); pediatric ICUs, neonatal ICUs, cardiac care
units, cardiac catheter labs, telemetry units, progressive care units, emergency departments,
and recovery rooms. Increasingly, critical-care nurses work in home health, managed care
organizations, nursing schools, outpatient surgery centers, clinics, and flight units.

Critical Care Nurse Duties and Responsibilities:

When a patient suffers a heart attack, stroke, shock, severe trauma, respiratory distress or
other severe medical issue, it is vital that they receive immediate and intensive nursing care.
Critical care nurses are adept at providing such care in settings where patients can be given
complex assessments and treatment.

Specific critical care nurse duties and responsibilities can include:

Assessing a patients condition and planning and implementing patient care plans
Treating wounds and providing advanced life support
Assisting physicians in performing procedures
Observing and recording patient vital signs
Ensuring that ventilators, monitors and other types of medical equipment function
properly
Administering intravenous fluids and medications
Ordering diagnostic tests
Collaborating with fellow members of the critical care team
Responding to life-saving situations, using nursing standards and protocols for
treatment
Acting as patient advocate
Providing education and support to patient families
Critical care nurses may also care for pre- and post-operative patients. In addition,
some serve as case managers and policy makers, while others perform administrative
duties.

Requirements and Qualifications for Critical Care Nurses:

Critical care nurses must first be registered nurses (RNs) with experience in general patient care.
Because of the complexity of patient care involved in this specialty, many employers hiring
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critical care nurses can show preference to applicants with Bachelor of Science in Nursing (BSN)
degrees. Some nurse education programs offer courses in critical care, but many practitioners
learn through field training in a hospital setting.

Many critical care nurses choose to earn the Certified Critical Care Nurse (CCRN) designation
offered through the American Association of Critical-Care Nurses (AACN).

Critical-care nurses must have education and training beyond their basic preparation as a
registered nurse (RN) to meet the needs of patients and families who are experiencing critical
illness. Most critical-care nurses will complete a critical-care training course or orientation that
includes essential information on the care of the critically ill patient.

Although certification is not mandatory for practice in a specialty like critical care, many nurses
choose to become certified. Some employers prefer to hire certified nurses, as they tend to
demonstrate a higher level of knowledge in their specialty and often have more specialty
practice experience. Certified critical-care nurses (CCRNs) validate their knowledge by passing
a rigorous test and by meeting extensive continuing
education and clinical experience requirements.

Characteristics and Skills of Critical Care Nurses:

Critical care nurses must be proficient in a wide variety of

high-level nursing skills. They need to be experts in
evaluating intensive care patients, administering care,
recognizing complications and coordinating with other
members of the critical care team. Successful critical care
nurses also excel at interpersonal communication,
leadership, strategic planning, critical thinking and
decision-making.

Work Environment:

Critical care nurses work in emergency rooms, critical care wards, walk-in clinics, doctor offices
and other healthcare settings. Because patients are treated around the clock, critical care
nurses are usually required to work rotating shifts that include days, nights, weekends and
holidays. The job can be physically demanding, as well, requiring standing, lifting, bending and
stretching.

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ADVANTAGES:

Resources: https://www.nursesource.org/critical_care.html

https://www.journals.elsevier.com/intensive-and-critical-care-nursing/

https://en.wikipedia.org/wiki/Critical_care_nursing

https://www.villanovau.com/resources/nursing/icu-critical-care-nursing-job-description/#.WQ66jPl97IU