Critical Care NursingCritical care nursing is a new specialty, which emerged in the 1950s and 60s in North America, Europe, South Africa and Australia and has been developing as a specialty within nursing for more than 30 years. As defined by the World Federation of Critical Care Nurses, critical care nursing is an advanced nursing care of critically sick patients who have evident disorder of crucial organ functions. It involves helping, supporting and reinstating the patient toward wellbeing, or to relieve the patients’ pain and to prepare them for a noble death.
The intent of critical care nursing is to develop a therapeutic association with patients and their families and to build the patients’ physical, emotional, sociological, educational and religious potentials through preventive, therapeutic, and rehabilitative strategies. Critically sick patients are those who are at high danger of actual or possible acute health problems. Critical care nursing can be strongly linked to intensive care unit (Scribante, Schmollgruber, & Nel, 2005). The early stages of critical care nursing included mainly of coronary care unit, cardiothoracic units, and the general intensive care units.
Coronary care units took care of cardiology patients, cardiothoracic units for postoperative patients whereas; general care unit took care for patients with respiratory problems. The principles of critical care nursing that exist today are as a result of later advance in renal, metabolic, and neurological management. Advancement in technology, such as the invention of machines like ventilators, cardiac monitors, pacemakers, defibrillators, dialysers and currently, intra-aortic balloon pumps have promoted the development of critical care as a specialty and of more expertise (Fairley, 2005). The recognition of the importance of the role of adequately trained and experienced nurses in these care units from an early stage have led to the development of nursing specialty of critical care (Keeling & Bigbee, 2005).
The development of critical care nursing was exemplified by a number of features: the foundation of a new organization between nursing and clinical staff; the experience of a vertical learning curve for nursing and clinical staff in accord; the guts to work in unfamiliar location, caring for terminally ill patients- a task that needed development of high-level of competence; and a high demand for education specific to the specialty of critical care nursing, which was at first hard to meet owing to the lack of qualified nurses in the field (Hanley & McEwen, 2005).
Critical Care nursing EducationThe specialty of critical care nursing education and professional organizations such as the Australian College of Critical Care Nurses (ACCCN) evolved with the evolvement of the practice of critical care nursing (ACCCN, 2005). Critical care nursing education involved the formalization of education for nurses to practice in critical care units and offer quality care to patients and their families.
This formal education, together with practical learning, ongoing professional development and training and insightful medical practices provided the expertise, knowledge and attitudes essential for quality critical care nursing practice as articulated in the competency standards of the ACCCN (Hravnak Tuies & Baldisseri, 2005). Critical care nursing education originally consisted of ad-hoc training, which was provided by clinical officers as there were no professional nurses available to provide the training. In the 1990s, universities developed postgraduates curricula in which they offered university-based critical care courses to extend the knowledge and skills of nurses.
This led to the discontinuation of hospital-based courses (American Association of Critical-Care Nurses 2006). Currently, most tertiary institutions offer postgraduate critical care nursing education at a Masters, Graduates, Diploma and Certificate level as preparation for specialty practice (American Association of Critical-Care Nurses 2006). An assessment of clinical competence remains an essential component of most university-based critical care nursing courses globally as relates to employment in critical care. The Declaration of Madrid, which was approved by the World Federation of Critical Care Nurses, offers a foundation for critical care nursing education globally (WFCCN, 2005).
The recruitment, orientation, training and development process is designed to allow continued retention of competent critical care nurses as a way of promoting quality critical care nursing practice (Aitken, Currey, Marshall & Elliot, 2006).