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Critical Care Nursing: Driving Excellence at the Bedside

July 2014

Although there have always been very ill and severely injured patients, the concept of critical care nursing is fairly contemporary. According to the American Association of Critical-Care Nurses (AACN), the specialty of critical care nursing began when the first intensive care units were created in the 1950s to provide care to critically ill patients who needed one-to-one care from a nurse. In 2013, the AACN reported more than 70,000 nurses across the country were certified as CCRNs. 

Critical care nurses practice within the hospital in intensive care units (ICUs), cardiac care units, pediatric or neonatal ICUs, telemetry units, emergency departments and recovery rooms. Critical care nurses can also work outside of the hospital walls, in homes, nursing schools or outpatient surgery centers. As technology changes and the nature of healthcare evolves, critical care nurses continue to use their specialized knowledge base, organizational skills, communication expertise and strong sense of compassion to provide acute patient care. 

The AACN is the largest specialty nursing organization in the world with more than 100,000 members who care for acutely or critically ill patients. Critical care nursing entails taking on a great deal of responsibility, but is also extremely rewarding, according to Karen McQuillan, RN, MS, CNS-BC, CCRN, CNRN, FAAN, president-elect of the AACN and a clinical nurse specialist at the R Adams Cowley Shock Trauma Center in the University of Maryland Medical System in Baltimore, Md.

“One important quality for critical care nurses is the ability to make quick decisions constantly,” she said. “Those decisions come from a strong knowledge base. Critical care nurses need to be up-to-date on new medications and technology, changing policies and procedures. Patients depend on highly knowledgeable and skilled nurses to make accurate assessments and prioritize needs.”

Additionally, McQuillan believes that critical care nurses need to be organized, detail-oriented and able to stay calm in an emergency while managing complex patient situations and patient care equipment. Critical care nurses work together with other nurses and health professionals with a single focus on caring for the patient and their family. Physicians, specialists, therapists, dieticians and everyone else involved in a patient's care come to them for the most current information.

“The critical care nurse often has a very good understanding of the patient's needs,” said McQuillan. “This is very important because many times, patients can't communicate for themselves, and critical care nurses are the liaison for their patients and the patients’ families to the healthcare team. Critical care nurses are advocates for their patients.”

McQuillan has learned through the AACN “to drive excellence at the bedside.” She also thinks it is an ideal goal for critical care nurses.

“It's the critical care nurse’s combination of skills that inspire patients and their families to trust them,” said McQuillan, “Nurses who deliver the best care, who drive excellence at the bedside, are those who can take book and technology knowledge and apply it in a compassionate and caring way.”

To learn more about critical care nursing, visit

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