Talk:Critical care nursing

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This page is still a work in progress, so bear with me.


[edit] The Intro

Regarding the introduction/overview of what critical care nursing is - this part should be expanded with a definition that includes information such as that from the American Association of Critical Care Nurses (AACN) in that a critical care nurse is a licensed professional nurse who provides care to acutely/critically ill patients and their families. Also, definine critically ill, such as those who are at high-risk for actual or potential life-threatening health problems. (see this - http://www.aacn.org/AACN/mrkt.nsf/vwdoc/AboutCriticalCareNursing?opendocument). The AACN page goes on to discuss this more.

Also,regarding the sentence under the Training and Education heading "All critical care nurses in the U.S. are registered nurses" - this simply is not so. Maybe in major cities all critical care nurses are RNs, but in rural areas where there is even more limited access to nurses (compounded by the current and escalating nursing shortage) the critical care areas do utilize LPNs making the "All" statement incorrect. I have seen LPNs working in ICU/ER/PACUs...etc. Granted, in an ideal world only RNs would staff the specialty units. Susannah 22:05, 4 December 2006 (UTC)


I know, I just haven't finished that part yet! :) I am still working on it. I was having trouble getting it all looking professional, learning to edit wikipedia and studying for finals at the same time. I appriciate the heads up on it.

Also, regarding the LPN issue. I am making the general statement that all critical care nurses are registered nurses not on the fact LPN/LVN's do not work in the intensive care units, as many of them do. I make the statement in the light of the the fact that that due to the unstable and rapidly changing nature of the patient population they (the LPN/LVN) cannot legally take primary care of this type of patient, as it requires rapid nursing assessments and interventions. For example, in Arizona, where I practice, the law states as I have posted below. So, in light of this, I will change it to reflect the role of the LPN/LVN in the intensive care setting, and will clarify their role and identify the scope of practice issues accordingly.

Another thing, please feel free to edit as you see fit to this page as you are obviously knowledgable source and I welcome your assistance with this page. --LucasRN 06:49, 12 December 2006 (UTC)

It appears that no edits have been made recently, so I may take a stab at revisions. FYI, I am a critical care nurse and professional staff at a small community college. I will wait a few days for comment, otherwise will plan to start revisions late June to early July. --Packae 07:30, 2 June 2007 (UTC)

[edit] LPN/LVN Issues

This is potentially a big problem for this article if not handled gently. There's a huge pride issue and rightly so. So I would suggest the following.

  • Acknowledge the role of LPN's in the critical care setting.
  • Acknowledge the primary role of the registered nurse.
  • Acknowledge the essential team element required for efficient patient-centered functioning of the unit.

I spent 10 years in critical as an RN and freely assert the vital role the LPN's played. However the RN is the primary caregiver and the article should so assert. To be absolutely precise, all critical care nurses are not RN's. Perhaps we could say that in critical care units, all primary care givers are RN's who are supported by LPN's and LVN's. Inasmuch as the word "nurse" is non-specific and LPN's and LVN's are so-called by the state licensing boards and since they do work in critical care, we shouldn't suggest they don't. I think a compromise is indicated. JodyB talk 15:21, 2 June 2007 (UTC)

Agree. I've worked with some great LPN's in the unit. While critical care may not be the most appropriate place fulfilling place for the LPN to work, as the LPN's scope of practice is limited by most nurse practice acts, that should be discussed in licensed practical nurse. --packae talk 21:42, 2 June 2007 (UTC)
Let me throw something out here for consideration. There is a stub at Nursing practice which might be a good place to differentiate the roles in a fuller form. Then this particular article could remain narrowly focused and could offer just a brief mention of the differences. A "see also" link could then send folks over to the other article. Now, that might work, might not but it's something to think about. Anyway, I agree with your concept. JodyB talk 22:58, 2 June 2007 (UTC)

JodyB, I was also an LPN for quite some time. I agree that not all nurses that work in critical care are RN's. I am also aware of the fact that due to the LPN/LVN's limited scope of practice, and the unstable nature of the patient population, it makes it extremely difficult if not impossible for the PN to assume primary care in the ICU. This was the point I am trying to make in this part of the article. This aside, I have worked with some very fine PN's in the unit, and this is in no way down playing their abilities. I modified the page to reflect this after suzanna brought this to my attention. I am grateful for your assistance, and always appricate constructive critism. I also appricate all of you trying to keep the focus of the article on the role, conditions and expectations fo the critical care nurse. --LucasRN 07:46, 12 June 2007 (UTC)

[edit] Nurse Practice Act, R4-19-401, Scope Of Practice, Arizona.

ARTICLE 4. REGULATION R4-19-401. Scope of Practice for a Practical Nurse A. A licensed practical nurse shall provide nursing care only under the supervision of a professional nurse or licensed physician. B. The scope of practice for a licensed practical nurse shall include planning, implementation, documentation, and evaluation of the following: 1. Providing for the emotional and physical comfort of patients; 2. Observing, recording and reporting the condition of the patients including signs and symptoms which may be indicative of change in the patient’s condition to the nurse’s immediate supervisor; 3. Performing those nursing activities for which the licensed practical nurse has been prepared through basic education and those additional skills which are obtained through approved continued education programs. 4. Assisting with the rehabilitation of patients in accordance with the patient’s care plan. Historical Note Former Section III, Part II; Amended effective February 20, 1980 (Supp. 80-1). Former Section R4-19-42 renumbered as Section R4- 19-401 (Supp. 86-1). Section repealed, new Section adopted effective July 19, 1995 (Supp. 95-3). R4-19-402. Scope of Practice for a Professional Nurse A. The scope of practice for a professional nurse shall include the following: 1. Performing those nursing activities for which the professional nurse has been prepared through basic education and additional skills which are obtained through approved continuing education programs; 2. Providing the nursing supervision in the planning for and provision of nursing care to patients and the directing and evaluating of nursing care provided by other licensed nurses and other personnel; 3. Providing patient education, both individualized and to the public; 4. Assessing the patient’s needs, planning for, implementing, evaluating, and documenting the nursing care being provided to each patient. B. A professional nurse shall be responsible both for the nursing care directly provided by the nurse and the care provided by others who are under the professional nurse’s supervision. —The preceding unsigned comment was added by Lucasmarcum (talk • contribs) 06:50, 12 December 2006 (UTC).