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CONCEPT OF CRITICAL CARE

INTRODUCTION The intensive care unit is not merely a room or series of room filled with patients attached to interventional technology; it is the home of an organization: the intensive care team. THE INTENSIVE CARE TEAM Doctor Nurses Therapists Nutritionists Chaplains and other support staff, builds an environment for healing or dying

CRITICAL CARE NURSING Critical care nursing is that specialty within nursing that deals specifically with human responses to lifethreatening problems. SEVEN Cs OF CRITICAL CARE Compassion Communication (with patient and family). Consideration (to patients, relatives and colleagues) and avoidance of Conflict. Comfort: prevention of suffering Carefulness (avoidance of injury) Consistency Closure (ethics and withdrawal of care).

CRITICAL CARE NURSE -A critical care nurse is a licensed professional nurse who is responsible for ensuring that acutely and critically ill patients and their families receive optimal care . WHERE CRITICAL CARE NURSES WORK ICU PEDRIATRIC ICU NEONATAL ICU

CARDIAC CARE UNITS CARDIAC CATHETER LABS TELEMETRY UNITS PROGRESSIVE CARE UNITS EMERGENCEY DEPARTMENTS RECOVERY ROOMS CRITICAL CARE UNIT Critical care unit is a specially designed and equipped facility staffed by skilled personnel to provide effective and safe care for dependent patients with a life threatening problem. WHAT CRITICAL NURSES DO Respects and supports the life of patients Intervene when the best interest of the patient is in question Help the patient obtain necessary care Respects the values, beliefs and rights of the patient Provide education and support to help the patient or the patients designated surrogate make decisions Represent the patient in accordance with the patients choices Supports the decisions of the patient or designated surrogate, or transferred care to an equally qualified critical care nurse Intercede for patients who cannot speak for themselves in situations that require immediate action Monitor and safeguard the quality of care the patient receives Acts as a liaison between the patient , the patients family and other healthcare professionals ROLES OF A CRITICAL CARE NURSE Bedside clinicians Nurse educators Nurse researchers Nurse managers Clinical nurse specialists Nurse practitioners Advanced practice nurse

LEVEL OF EDUCATION FOR CRITICAL CARE NURSES Diploma in nursing Associates degree in Nursing(ABN) Bachelors Degree in Nursing(BSN) NLE Advance Practice nurses: Masters or Doctoral level THE AIM OF THE CRITICAL CARE: To see that one provides a care such that patient improves and survives the acute illness or tides over the acute exacerbation of the chronic illness. THE EVOLUTION OF CRITICAL CARE Forty years of development in critical care and critical care nursing has given rise to a recognized speciality in nursing practice . Critical care units have evolved over the last four decades in response to medical advances . HISTORICAL PRESPECTIVES Florence nightingale recognized the need to consider the severity of illness in bed allocation of patients and placed the seriously ill patients near the nurses station. 1923, John Hopkins University Hospital developed a special care unit for neurosurgical patients . Modern medicines boomed to its higher ladder after world war 2

As surgical techniques advanced it became necessary that post operative patient required careful monitoring and this came about the recovery room. In 1950, the epidemic of poliomyelitis necessitated thousands of patients requiring respiratory assist devices and intensive nursing care. At the same time came about newer horizons in cardiothoracic surgery, with refinements in intraoperative membrane oxygen techniques.

In 1953, Manchester Memorial Hospital opened a four bedded unit at Philadelphia was started. By 1957, there were 20 units in USA and

In 1958,the number increased to 150. CONTEXTUAL FORCES The expansion of American hospital system and hospital insurance. Architectural, hospital changes towards private and semi private accommodations. Reallocations for direct patient care responsibility and creations of new forms of care. During 1970s,the term critical care unit came into existence which covered all types of special care

TYPES OF ICUs There are two types of ICUs, An open : In this type, physicians admit, treat and discharge and

A closed: in this type, the admission, discharge and referral policies are under the control of intensivists. ICUS CAN BE CLASSIFIED AS: Level I: This can be referred as high dependency is where close monitoring, resuscitation, and short term ventilation <24hrs has to be performed. Level II: Can be located in general hospital, undertake more prolonged ventilation. Must have resident doctors, nurses, access to pathology, radiology, etc. Level III: Located in a major tertiary hospital, which is a referral hospital. It should provide all aspects of intensive care required. FUTURE OF CRITICAL CARE NURSING Rapid advances in healthcare and technology have contributed to keeping more people out of the hospital. However, patients in critical care units are more ill than ever. May patients who would have been cared for in a critical care unit five years ago are now being cared for on medical floors or at home. Many patients in todays critical care units would not have survived in the past. It has been proposed that hospitals of the future will be large critical care units and other types of care will be provided in alternative locations or at home. Critical care nurses will need to keep pace with the latest information and develop skills to manage new treatment, methods and technologies. As issues relating to patient care become increasingly complex and new technology and treatment care introduced, Critical care nurses will need to become ever more knowledgeable.