Your browser is no longer supported

For the best possible experience using our website we recommend you upgrade to a newer version or another browser.

Your browser appears to have cookies disabled. For the best experience of this website, please enable cookies in your browser

We'll assume we have your consent to use cookies, for example so you won't need to log in each time you visit our site.
Learn more

Lee Goodare discusses critical care

  • Comment

VOL: 98, ISSUE: 40, PAGE NO: 31

Lee Goodare is assistant clinical editor, Nursing Times

Critical care is not confined to patients in high dependency units. Those on the wards can suddenly become critically ill and patients in need of critical care may be placed on acute wards because of shortages of intensive care beds. This puts ward nurses in a difficult position in terms of critical care skills because a patient may be deteriorating after surgery and critical care interventions may be needed urgently.

Critical care is not confined to patients in high dependency units. Those on the wards can suddenly become critically ill and patients in need of critical care may be placed on acute wards because of shortages of intensive care beds. This puts ward nurses in a difficult position in terms of critical care skills because a patient may be deteriorating after surgery and critical care interventions may be needed urgently.

With luck, a nurse will be there to notice the deterioration and, if appropriately trained, will give the patient the input required.

Serious problems arise when these needs are not met. And even when they are met, it is essential to have enough staff to care for the non-critical patients who are on the ward.

Philip Woodrow (p32) looks forward and discusses an initiative by East Kent Hospitals NHS Trust to provide training for ward nurses delivering critical care.

When I worked on acute wards I would often have: 10 other patients to care for; oral, enteral, nasogastric and intravenous drugs to administer; meals to give out; four patients waiting for non-existent beds; and bags of IV fluids to keep to time. There would also be mouth care for palliative patients, caring for wounds and central lines, and the mentoring of a student. Many nurses will realise that this list is not hyperbolic.

A patient who becomes critically ill on a ward requires the full attention of trained staff. Comprehensive Critical Care (DoH, 2001) states that a patient's needs are determined by the level of care that his or her condition requires, not by the designation of the bed in which the person happens to lie. But this is not the case as such situations still happen, compromising the well-being of all patients on the ward and wearing down even the most experienced nurses.

The feedback from the staff who have attended the course run by Mr Woodrow has been positive. As always, nurses are eager to refine and expand their existing skills and such initiatives can empower them and boost their morale.

But nurses also require a workplace with the infrastructure to support their knowledge and enable it to be used. The provision of a safe ratio of staff to patients is the only way that this can happen. Until then, luck will continue to play a significant and disturbing part in critical care interventions at ward level.

  • Comment

Have your say

You must sign in to make a comment

Please remember that the submission of any material is governed by our Terms and Conditions and by submitting material you confirm your agreement to these Terms and Conditions. Links may be included in your comments but HTML is not permitted.