Critical Care Nurse And What Kind Of Patients Do They Care For?

Relationships among workers in the ICU of Changeable Medical Center are at best, strained. In the past six months, the unit has expanded from 8 to 12 beds, changed to a different electronic health record vendor, and changed unit managers. Ten of thirty registered nurses have resigned or left, two of the remaining twenty are out on sick leave, and absenteeism is at a record high. As the new unit manager, you are looking for ways to improve morale and deal constructively with the many problematic relationship issues.

The ICU should be equipped with a recliner in every patient room, therefore 12 more recliners need to be purchased. Signage inside the patient’s room can be made by printing and laminating the AACN Early Progressive Mobility Protocol from their website with minimal cost. Total estimated cost including 12 recliners and staff education time: $ 10,200. Re-teaching will be implemented at staff meetings on a quarter-yearly basis and the ICU nurses will have the opportunity to provide constructive feedback. HCAP statistics will provide data regarding length of stay in the ICU, Ventilator and Health-care Acquired Pneumonias and Wound care will contribute the data for Decubitus occurrence.

This paper is an academic critique of an article written by Lautrette, et al. (2007) titled: “A Communication Strategy and Brochure for Relatives of Patients Dying in the ICU” and accurately reflected the content of the article and the research study itself. The abstract explained the article in more detail, while remaining concise. The type of research study, sample size, variables, intervention, measurement method, findings, and conclusion were all mentioned in the abstract.

I stepped behind the front desk of Spirit Medical Center’s emergency room to begin the night shift of April 23, 2002. Half of the rooms were already filled and my coworkers busied themselves moving throughout the sterile halls. If it weren’t for my pager calling me and two other nurses to take on a patient that would be arriving shortly in an ambulance, I would have been a part of the rush. Meanwhile, I observed the friends and families that occupied the uncomfortable wooden chairs in the waiting room. The majority of them wore a somber expression on their faces, but there were the few that had tears streaming down their cheeks uncontrollably as they took advantage of the conveniently located tissue boxes. My observations were soon distracted by the sound of approaching sirens.

Restricting family presence contradicts patient- and family-centered care (PFCC). Within the PFCC paradigm, the patient and family relationship is recognized as an inseparable entity. Encouraging unrestrictive family presence through an open visitation policy can ensure patients and family members are provided with the opportunity to remain connected during a hospitalization experience.1 Despite professional organizations for critical care nursing and patient- and family-centered care advocating for unrestrictive family presence, many critical care units have not adopted an open visitation policy. According to the American Association of Critical-Care Nurses (AACCN),

Some family members seen family presence not only as an essential right but likewise as a mode of giving support to their loved ones in this emergency of life crisis. Though, some family could have concern about feeling sensitively traumatized and beholden to observe the code when families may prefer to decline. Patients besides believed that the family had the right to have their families present. Some patients alleged to felt safer and less frightened when family was present. But, other patients described that they desired to face death alone and did not want estranged folks to be permitted to invade their own privacy. Healthcare workers seen family presence as an occasion to preserve the self-respect and personhood of patients but be frightened physical assault by distressed family members, augmented threats of legal responsibility and subsequent litigation, and loss of control above the code situation. Captivatingly, all parties involved arranged that family presence during the code could result in exposing patients to extended resuscitations in medically fruitless circumstances because the trauma team may be unwilling to call the code in the presence of the family of the patient. In the past decade, nurses have progressively promoted for family presence. Nurses mostly agree that family presence could be favorable for both patients and families, if patients and families wish it. For the reason of this belief, nurses endure to advocate for their patients by making an effort to revise policies that limit family presence in the

An interpretative phenomenology study is titled Family Presence During Resuscitation: A Double Edge Sword (Hassankhani et al., 2016, p.127). Family presence during resuscitation of a loved one can have benefits and risks (Hassankhani et al., 2016, p. 127). According to Hassankhani, Zamanzadeh, Rhmani, Haririan, and Porter (2016), family presence during resuscitation means that the patient’s family arrived or were already present where the resuscitation is taking place, which means that the family members can see and touch the patient (Hassankhani et al., 2016, p. 128). Some of the hesitations that medical staffs have about family being present include environmental, cultural, and social factors (Hassankhani et al., 2016, p. 128). Another factor that can be involved are the previous experiences that the medical staff has had with family presence during resuscitation (Hassankhani et al., 2016, p. 128). These experiences can have a positive or negative affect on the medical staff and affect their allowance of other family members during a resuscitation (Hassankhani et al., 2016, p.128). The study conducted by Hassankhani et al. (2016), included 12 nurses and 9 doctors in Iran that were interviewed about their feelings of family presence during resuscitation for 6 months (p. 128). The participants of this study worked in the most crowded hospitals and worked together during the resuscitation (Hassankhani et al., 2016, p. 128). The nurses in this study had to have at least a bachelor’s degree and the doctors had to have at least a general medical degree; all participants had to have 2 years of clinical experience (Hassankhani et al., 2016, p. 129). Initially, there were 500 codes during the 6 months (Hassankhani et al., 2016, p.129). After the interviews were conducted there were two themes identified: destructive presence and supportive presence (Hassankhani et al., 2016, p. 129). The destructive presence theme included the medical staff experiencing family interruption in their attempt to save the patient (Hassankhani et al., 2016, p. 130). One instance of this involved a family telling the doctor what medications should be given (Hassankhani et al., 2016, p.130). Another occurrence a nurse

Jean Watson’s Caring theory has been used in the development of many nursing conceptual models (Fawcett & DeSanto Madeya 2013). One of the tools derived from this theory is the daily goals sheet used in a variety of ICU’s around the country (Fawcett & DeSanto Madeya 2013). The daily goals sheet was derived as a way to improve patient care by keeping the patient safe, provide reliable care, improve communication between doctors and nurses, and help the nurse plan for the day (Rehder, Uhl, & Mistry, 2012). According to Fawcett and DeSanto Maydeya (2013), the goal of Watson’s theory is to help nurses become more “nursing-qua-medicine,” where nursing “needs to emerge as mature health profession, capable of interfacing with the medical profession” (2013 p. 405-406). An interdisciplinary care team was used to implement a time with no interruptions between providers. This time was used to discuss the care of the patient, include families, and ensure that all members agree of the care to be provided (Rehder, Uhl, & Mistry 2012). By having the nurses be a part of this team, they are able to interact and be a member of the team, which is the goal of Watson’s caring theory (Rehder, Uhl, &Mistry 2012). If there is teamwork, and all the members of the team understand the goals, then the daily goals can help decrease length of stay (LOS) in ICU’s, decrease hospital acquired infections

What does it mean be a registered nurse? To some, it may be someone who goes and fetches a cup of water or a cup of coffee. Perhaps it is someone who just provides the patient with warm blanket and a pat on the head; or just maybe someone who delivers medications to the patients. A registered nurse (RN) may provide those services, but there is much more behind the scenes of planning that the patient may not realize. A RN is also responsible for the proper delegation of care to the patients under his/her care with the appropriate staff that is suited for such tasks. For example, a RN may delegate the CENA’s (Competency Evaluated Nurse Aides) to take vitals on a patient while the LPN/LVN

The American Association of Critical-Care Nurses, state that there are several factors that lead to successful, healthy work environments. “The ingredients for success — skilled communication, true collaboration, effective decision making, appropriate staffing, meaningful recognition and authentic leadership” (American Association of Critical-Care Nurses, 2016, para. 4). However, I have to disagree to the idea that the nurses’ work environments are totally at blame. What are the main causes of unhealthy work environments? There are several elements that lead to unhealthy work environments such as job stressors, different work environment perceptions, and unique employee characteristics.

The goal of this paper is to provide a policy to make changes to the Intensive Care Unit (ICU) at Mercy Hospital

Critical care nurses provide advanced nursing care for patients in critical or cornary care units. The preparatin required to become a critical care nurse education wise most occupations require training in vocational schools, related on-the-job experience, or even a associates degree. The job training required however employees usually need any where from one to two years of training involving both on-the-job and informal training with experiened workers.

Lily had only recently began dialysis treatment, and her unwillingness to proceed with treatment would have resulted in her care becoming palliative, something the healthcare professional did not think was suitable at this point in her illness trajectory. Tait (2012) points out that a critically ill patient experiences not only physiological trauma, but also psychological trauma. This psychological trauma that can be experienced after critical care has been addressed by the National Outreach Forum (2003) who suggested that services should be developed to address the implications of critical illness. Samuelson (2011) suggests that any negative emotions associated with critical care can be counterbalanced with memories that reinforce safety, control and trust. This is a useful point to consider in Lily case, who fortunately had the time to talk through her worries concerning continual dialysis treatment with the staff on the ward, who were able to convince her she was in the safest possible hands and that continuing her dialysis treatment would be the best option.

In Bed Number Ten, Sue Baier shares her first-hand account of both her painful experiences and her lengthy recovery in the ICU setting. She was struck with the disabling effects of Guillain-Barre syndrome which resulted in her being admitted into an Intensive Care Unit. While there, her communication and mobility was very limited and made it very difficult for many of the staff to passionately and effectively take care of her. She describes multiple accounts of nurses and staff who were task oriented and failed to meet her physical and emotion needs. Her sense of isolation and inhumane treatment transpires from the pages to the heart of the reader. However, in the book, we observe a few staff that were sensitive to her condition and took care of her the way a person should be taken care of. Sue’s hardship and experience is one of perseverance in her time in the ICU and gives an outlook of how to be sensitive to critical care patients, as it should be.

The American Association of Critical-Care Nurses (AACN), the world’s largest specialty nursing organization, has been serving the needs of nurses caring for acutely and critically ill patients since 1969. Representing the interests of more than 500,000 nurses who care for acutely and critically ill patients, AACN is dedicated to creating a healthcare system driven by the needs of patients and their families, where acute and critical care nurses make their optimal contribution (American Association of Critical-Care Nurses, 2016).