Critical care nursing

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, paediatrics and some trauma center emergency departments. These specialists generally take care of critically ill patients who require mechanical ventilation by way of endotracheal intubation and/or titratable vasoactive intravenous medications. 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, paediatrics and some trauma center emergency departments. These specialists generally take care of critically ill patients who require mechanical ventilation by way of endotracheal intubation and/or titratable vasoactive intravenous medications. Critical care nurses are also known as ICU nurses. They treat patients who are acutely ill and unstable requiring more frequent nursing assessments and the utilization of life sustaining technology and drugs. Although many ICU patients have chronic health issues, patients are in the ICU for an acute pathology or an exacerbation of a chronic pathology. ICU nurses 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 nurses in the U.S. are trained in advanced cardiac life support (ACLS), and many earn certification in acute and critical care nursing (CCRN) through the American Association of Critical–Care Nurses. Due to the unstable nature of the patient population, LPN/LVNs are rarely utilized in a primary care role in the intensive care unit. However, with proper training and experience LPN/LVNs can play a significant role in providing exceptional bedside care for the critically ill patient. To become a critical care nurse, one must first achieve an associate or bachelor's degree in nursing and pass the National Council Licensure Examination (NCLEX-RN). Once the exam is passed, then someone can start working as a regular registered nurse (RN). After getting hired into a critical care area, additional specialized training is usually given to the nurse. After 1750 hours of providing direct bedside care in a critical care area, a nurse can then sit for the CCRN exam. The American Association of Critical Care Nurses advisory board sets and maintains standards for critical care nurses. The certification offered by this board is known as CCRN. Depending on the hospital and State, the RN will be required to take a certain amount of continuing education hours to stay up to date with the current technologies and changing techniques. Registration is a regulatory term for the process that occurs between the individual nurse and the state in which the nurse practices. All nurses in the US are registered as nurses without a specialty. The CCRN is an example of a post registration specialty certification in critical care. There are also variants of critical care certification test that the AACN offers to allow nurses to certify in progressive care (PCCN), cardiac medicine (CMC) and cardiac surgery (CSC). In addition, Clinical Nurse Specialists can certify in adult, neonatal and pediatric acute and critical care (CCNS). In November 2007, the AACN Certification Corporation launched the ACNPC, an advanced practice certification examination for Acute Care Nurse Practitioners . None of these certifications confer any additional practice privileges, as nursing practice is regulated by the individual's state board of nursing. These certifications are not required to work in an intensive care unit, but are encouraged by employers, as the tests for these certifications tend to be difficult to pass and require an extensive knowledge of both pathophysiology and critical care medical and nursing practices. The certification, while difficult to obtain, is looked upon by many in the field as demonstrating expertise in the field of critical care nursing, and demonstrating the individual's nurse's desire to advance their knowledge base and skill set, thereby allowing them to better care for their patients. Intensive care nurses are also required to be comfortable with a wide variety of technology and its uses in the critical care setting. This technology includes such equipment as hemodynamic and cardiac monitoring systems, mechanical ventilator therapy, intra-aortic balloon pumps (IABP), ventricular assist devices (LVAD and RVAD), continuous renal replacement equipment (CRRT/CVVHDF), extracorporeal membrane oxygenation circuits (ECMO) and many other advanced life support devices. The training for the use of this equipment is provided through a network of in-hospital inservices, manufacturer training, and many hours of education time with experienced operators. Annual continuing education is required by most states in the U.S. and by many employers to ensure that all skills are kept up to date. Many intensive care unit management teams will send their nurses to conferences to ensure that the staff is kept up to the current state of this rapidly changing technology. In Australia there is no compulsory prerequisite for critical care nurses to have postgraduate qualifications. However, the Australian minimum standard recommends that critical care nurses should obtain postgraduate qualifications. Critical care nurses must have a bachelor of nursing, be registered with the Nursing and Midwifery Board of Australia, and meet the NMBA’s standards in order to work as a critical care nurse in Australia.