Critical care nurses (CCNs) capably manage and coordinate the care of severely ill patients suffering from complicated medical or surgical illnesses. They possess high-level skills and balance multiple requirements as these patients are frequently intubated, on multiple IV drips, and have unstable cardiac or other organ failure risk. CCNs quickly identify when a patient decompensates and alert the rest of the critical care team. Critical care nurses also deliver emotional and psychological support to patients and their families.
Patients are often unconscious, but critical care nurses must always pay attention to easing their and their loved one’s fears. In addition, critical care nurses are responsible for their patient’s recovery from life-threatening injuries or illnesses. They are the true masters of delivering lifesaving care.
Intensive care units are often divided into different subunits, such as medical ICU, surgical ICU, pediatric ICU, and neonatal ICU. In some hospitals, there are additional divisions for cardiac care, trauma care, neurological treatment, and progressive or step-down units. Critical care nurses encompass all those who deliver care in any of these designations, and they can further specialize based on their interests.
Critical care nurses often receive advanced training to improve their skills. Some become advanced practice registered nurses (APRNs) or clinical nurse specialists (CNSs) who specialize in an area of interest within critical care.
Critical care nurses perform some of the same activities as other nurses, but they focus on the life-sustaining treatment and recovery of critically ill patients. CCNs typically care for one to two patients in the adult intensive care population and one to three patients in the pediatric or neonatal population.
General activities may include:
• Assess and monitor patients for changes in ventilation, cardiac and renal status
• Administer IV medications, dressing changes, catheter care, and prevent skin breakdown
• Manage cardiac monitors, ventilators, and other monitoring equipment
• Track and record patient progress, draw lab work, administer blood, maintain airways, provide wound care, and administer nutritional support
• Attend rounds with the care team, report on patient status, and assist physicians with patient treatments.
• Provide family and patient reassurance and teaching
• Provide comfort for end-of-life care
Critical care nurses must be specifically trained in their specialty area. For example, an adult care CCN does not work with pediatric or neonatal critical care patients.
CCNs need advanced assessment skills and IV drug knowledge of drugs that need frequent adjustments based on the patient’s status, such as dopamine as well as resuscitation medications. They have knowledge to run sophisticated equipment to manage ventilators, arterial lines, EKG monitors, intracranial pressure monitors, and multiple infusion pumps.
CCNs must be able to anticipate all their patients’ needs as patients are either too young or not able to verbalize desires, concerns, or discomforts.
