According to Heather Morey, BSN, RN, CEN, the most challenging and rewarding aspect of critical care nursing is one in the same: there is always an opportunity to learn more about the specialty.
Morey is the nurse manager of the Intensive Care Unit (ICU) at Munroe Regional Medical Center in Ocala, Fla. According to Morey, critical care nursing requires a commitment to continuing education and a particular passion for investigation.
“A critical care nurse becomes a lifelong learner,” she said. “Critical care nursing is ever evolving. We work with the latest technology, so it is important to constantly stay up-to-date.”
Michelle Post, RN, BSN, SCRN, a critical care nurse at the Neuroscience Intensive Care Unit (NSIC) at Miami Valley Hospital in Dayton, Ohio, agrees.
“Healthcare and medicine are constantly changing and this is even more apparent in the critical care setting. It seems that every week there is a new piece of equipment or new policy or procedure. Patients are changing too. New diagnoses and more complicated co-morbidities are making their way to our ICUs every day. To provide ample care for our patients, critical care nurses have to make education a top priority, especially as the nursing profession becomes more and more evidenced-based practice focused.”
The American Association of Critical-Care Nurses offers news and information for nurses, to help them stay savvy on the latest tools, technology and research. Many critical care nurses also take continuing education courses to learn a particular skill and broaden their understanding of their multidisciplinary specialty.
Morey’s unit at Munroe Regional Medical Center has won the American Association of Critical-Care Nurses’ Beacon Award for Critical Care Excellence five times. The Beacon Award recognizes the top U.S. critical care and progressive care units, highlighting exceptional care and great overall patient satisfaction, as well as a positive, supportive and collaborative work environment. One reason that Morey thinks the Munroe ICU unit has received the award an unprecedented number of times is because of emphasis by leadership on providing opportunities for nurses to keep learning, as mentors, researchers and students.
“We have a structure, which includes a unit-based council and a research team, that allows us to look for and implement evidence-based practice,” she said.
Morey explained that, in addition to being lifelong students of their specialty, critical care nurses must also be innately curious and interested in learning about their patients. One unique aspect she noticed about her job at the ICU is that the ratio of nurses to patients is smaller than a typical nursing unit, for example, in Morey’s unit, the ratio is two to one. Given that, critical care nurses have an opportunity to learn more about their patient’s health, leading to greater prevention of future illness.
“The thing about critical care nursing,” explained Morey, “is that you need to possess a particular interest in problem-solving, using critical thinking to explore what is causing the patient’s acute symptoms. In the ICU, we are working against the clock to figure out why our patients are sick. It’s ultimately about figuring out the ‘why’ behind the issue.”
Post says there are avenues critical care nurses can take to continue learning about critical care nursing, including seeking certification or additional training. She is currently working on her Master of Science in Nursing and recently became a Stroke Certified Registered Nurse (SCRN).
“Critical nurses can expand their knowledge base by attending graduate school or getting a specialty certification in critical care, stroke, wound, etc.,” Post said. “I read critical care journals, precept and attend classes and skills labs on critical care and stroke-related topics."
Nurses can also keep up on the latest research and data by joining a nursing organization and reading their publications.
"Nurses can participate in the research themselves by taking part in a study that is already being conducted," said Post. "Or nurses can propose and conducting a study themselves. For example, I participated in research in my Neuroscience ICU on the use of a new drug on ischemic stroke patients after tPA administration.”
Critical care nurses are also often called to be educators, sharing their knowledge and helping patients and their families navigate through test results and advanced technology to understand their diagnosis and care plan. Morey believes an important role for critical care nurses is advocating for their patients, often serving as a constant presence among the large range of specialists involved in treating patients in the ICU.
According to Morey, although critical care nursing is fast-paced, the core of the specialty is in the small, quiet moments with their patients.
“I always encourage my new nurses to develop their physical assessment skills. On the ICU floor, there are many monitors and machines that can be distracting, but the important thing has always been, and always will be, the interaction with the patient," said Morey.
“A majority of our patients come to the NSIC experiencing devastating injuries," she said. "Families are confused, scared and completely overwhelmed by the technology, equipment and the never ending medical jargon. When I admit a patient, I treat the patient and their families how I would want to be treated if roles were reversed. Simply explaining the monitors and equipment, plan of care and being upfront, honest and really listening makes all the difference.”
Critical care nursing may be a unique specialty and one that is constantly evolving, but there are common aspects for any nurse.
“In order to be a nurse,” said Morey, “you must feel a special calling. You must be passionate about healthcare and working with patients. Nurses have the opportunity to make a difference in the lives of their patients and their patient’s families every day.”
For more information about critical care nursing, visit the American Association of Critical-Care Nurses website at www.aacn.org.