If you're a specialized travel nurse who frequently works in critical care situations, there's a chance you're familiar with routine practices. The need for these standards makes sense, as many of the patients you see are enduring conditions that could impact their mortality. Everything needs to conducted to ensure that their care is taken seriously and responsibly.
Critical care in the nursing world
As such, nurses have to be vigilant in these hospital settings, especially because many of them are responsible for the patient well-being in the U.S. According to the American Association of Critical-Care Nurses, more than half a million U.S. nurses provide treatment to people in a critical setting, representing around 37 percent of the total number of nurses who work for U.S. patients.
These standards are practiced in many types of environments, including ERs, ICUs, neonatal and pediatric ICUs, cardiac care centers, telemetry units, standard ICUs and recovery wings. These standards are also utilized at a progressive rate in nursing schools and home healthcare, among others.
However, at least five critical care routine practices came under fire in 2014 by the AACN, according to Nurse.com. These proposed changes include:
- Only ordering diagnostic tests in response to specific clinical inquiries. In the past, the standards would require these to be ordered daily in some cases.
- Not keeping patients in deep sedation (unless otherwise noted) without some periods where lightening sedation is tried on a daily basis.
- If patients in critical care are fed adequately during their first week in the ICU, parenteral nourishment should not be used.
- Removing the transfusion of red blood cells in patients who are hemodynamically stable and not bleeding with a hemoglobin concentration over 7 mg/dL.
- If patients are at a high risk of mortality or may be severely impaired in their functional recovery, nurses should not continue life support without first offering alternative care to patients and their families focused on their comfort levels.
Research shows critical care work settings matter
Standards are important in critical care settings, regardless of these proposed changes from the AACN, and there is research that proves it. For instance, a study published in May 2014 in the journal Critical Care Medicine looked at 303 adult acute care hospitals from California, New Jersey, Pennsylvania and Florida in order to focus on the high mortality rate of patients who were mechanically ventilated in ICUs.
In all, more than 55,000 patients were examined in the study from 2006 to 2008, and researchers looked at Medicare claims data and other administrative information to draw their conclusions. In the end, they determined that patients who were treated in hospitals with higher percentages of critical care nurses had lower rates of death while receiving care.
Becoming a critical care nurse
It is not mandated that nurses become certified in critical care before they choose to work in such high-risk environments. However, many nurses choose to do so because the standard of care requires a high level of medical expertise that can help them gain an edge over other candidates.
The AACN states that the nursing shortage is also impacting these specialties, especially in adult, pediatric and neonatal ICUs as well as ERs. As a result, some providers are promoting critical care orientation programs and Web-based training to better prepare newly licensed RNs for these types of medical settings.
While a travel nurse should have at least two years of experience before taking assignments, it might be in your best interest to become certified in critical care to expand your portfolio and provide a higher standard of patient care for those who need it most.