Critical Care Nursing Career Tips

Critical care nursing is the specialty within the nursing profession that ensures the delivery of optimal care to acutely and critically ill patients. Critically ill patients are patients who are at high risk for actual or potential life threatening health problems. These patients are highly vulnerable, unstable, and have complex healthcare needs that require vigilant and intense nursing care.

These types of nurses and nurse practitioners are essential in intensive care units (ICUs), including medical, surgical, pediatric and neonatal ICUs, cardiac care units, cardiac catheter labs, telemetry units, progressive care units, emergency departments, and recovery rooms. Critical care nurses are also part of medical evacuation and transport teams.

In the United States, most critical care nurses are registered nurses; because of the unpredictable nature of the patient population, licensed practical nurses (LPNs) and licensed vocational nurses (LVNs) rarely assume the primary care role in caring for critically ill patients.

Registered nurses can obtain certification in critical care nursing through the American Association of Critical Care Nurses (AACCN), an advisory board that sets and maintains standards for critical care nurses. This certification, known as the CCRN, describes the holder as a certified critical care nurse for adult, pediatric and neonatal patient populations.

Several subspecialties of this type of nursing can be found in units composed of similarly aged patients. These subspecialties are in the following areas:

• Neonatal Intensive Care Unit, also called Nursery ICU or NICU. The NICU’s patients are primarily newborn and premature infants who are cared for until they reach the gestational age of one month. After this period, their care will be assumed by the Pediatric Intensive Care unit.
• Pediatric Intensive Care Unit, or PICU. Here, the patients are about one month to eighteen years of age.
• Adult Intensive Care, or ICU, takes care of patients who are beyond eighteen.

There may, however, be deviations from the above setup, such as sending newborns who get admitted in the Emergency Department to the PICU, rather than the NICU. There may be rare cases where an adult patient with congenital heart disease will be admitted to the PICU, as their current treatment is a continuation of treatment they had been receiving from their physicians since they were children.

Care subspecialties may also be based on the type of disorder, disease or primary injury of the patient population. For example, the Adult Intensive Care Unit may have a specialized unit for trauma patients called the Adult Trauma Intensive Care Unit.

There is a variety of equipment used in the critical setting with which intensive care nurses need to be thoroughly familiar. These include hemodynamic and cardiac monitoring systems, mechanical ventilator therapy, intro-aortic balloon pumps, ventricular assist devices, continuous renal replacement equipment, and other advanced life support devices. All of these are at the critical care nurse’s disposal when providing medical intervention to the critically ill.

With advances in healthcare and technology, medical conditions previously described as critical can now be treated outside the critical units. Nonetheless. critical care nurses continue to keep abreast with new treatment methods and technologies in this growing profession.

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The Ins and Outs of the Critical Care Nursing Field

Whenever the term critical care is mentioned – most people immediately think about severely sick patients in intensive care units or ICUs. They are not mistaken. Intensive Care Units and Critical Care specialized areas in the hospital that care for patients in need of intense and one on one attention. These are the areas where a critical care nurse Practices.

What is a Critical Care Nurse

A Critical Care Nurse or a CCN is a highly specialized nurse that has been trained to work in Intensive Care areas. They are nurses that care for patients who are severely ill and in need of individualized care. A CCN cares for patients of all diagnoses and gender. Patients may vary depending on this category. Critical care nurses also deal with complex technology that helps sustain patients.

The History

This type of nursing is a relatively new nursing specialty. It wasn’t until the 1950’s that the very first Intensive Care Units appeared in the Western world. These units were created to deal with gravely ill patients. They were considered to need a more intensive form of care compared to the patients in the regular wards. The notion of an intensive care unit quickly spread. Today, most hospitals are required to have these specialized areas and in turn specialized nurses and physicians to run them.

Back then, nurses assigned in CCUs and ICUs were not seen as different from regular ward RNs. It was only a few years later that CCN was considered as a specialized nursing field.

Roles of a CCN

Like any other registered nurse, the roles of the critical care nurse are very complex. These nurses have to deal with severely ill patients. They also need to be familiar with complex technologies that are continually present in a critical care setting. The critical care nurse also has to know basic and advance life support. Such skills may be called upon at any point during his/her service.

The critical care nurse must also be skilled in the art of diagnosis. He/she must be able to diagnose and identify a patient’s immediate needs. This part of nursing is important as it may be the difference between life and death for a patient. Nonetheless, the nurse must remember that despite being skilled at diagnosis, one must not overstep her boundaries and perform roles reserved for a physician alone.

Aside from dealing with patients and their needs, the CCN also has to deal with the patient’s family. The CCN often works as a counselor that helps the family get through the crisis at hand. He/she may have to deal with questions and concerns from the patient’s immediate family and significant others.

Qualifications and Requirements

IN THE PHILIPPINES – Locally, any registered nurse can become a critical care nurse. It is only a matter of area assignment. Most of the time, nurses who are assigned in critical care units are those who have shown promise in their previous areas of exposure. They are also the ones who have worked in similar areas such as medical/surgical or pediatric units.

ABROAD – Abroad, in the US specifically, there are no specialized requirement to be a critical care nurse other than an RN License. However, there are bodies of authority that certify CCNs.

Although, certification is not required, most CCNs abroad are choosing to go for it because it increases their credibility. Employers also often require their CCNs to be certified in the field. Certification is achieved post graduation. It is not something taught in school. Some schools may expose their students to ICUs, but this is not considered enough for certification. The RNs get their CCN certificates while they are on the job. It is also often sponsored by the employer.

Work Opportunities in the Philippine Nursing Scene

There are a lot of opportunities to become a critical care nurse in the Philippines. But, nurses have to understand that these critical care units are often hard to get into. These units only require a limited number of nurses. Most of the time there are only a total of 12 nurses that work in a typical ICU with 8-10 beds.

Those who do get into these areas are considered lucky because their position opens great opportunities to work abroad. In most settings, CCNs have a lesser work load compared to nurses in large wards. Patients in ICUs need more attention but the numbers are much smaller compared to wards. A typical government hospital ward may hold 50-70 patients and with only a nurse or two to manage it.

Work Abroad

There are a lot of work opportunities for a critical care nurse abroad. The CCN can work in any area where there is an intensive care unit. Certification is often an option provided by employers to deserving and promising nurses. The employers are often the ones who fund certification seminars and the likes.

With the present shortage in nursing manpower, hospitals are clamoring to get their hands on specialized nurses. These employers would often offer big sign-in bonuses just to get a nurse to work with them. The average salary of a critical care nurse in the US often ranges from USD50,000 – USD 75,000. It is estimated that nearly 70% of the critical care nurse population earn that much. Some earn slightly lower while others earn upwards of USD90,000 to USD100,000 annually.

From: Carmela Bignotia

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