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Qureshi University College of Nursing
Nurse, Intensive Care Unit
What should a nurse in an intensive care unit know?
Annotation or definition.
Duties of nurse in an intensive care unit compared to an intensivist and guide to intensivist.
Guidelines from any other resources.
Questions you must be able to answer.

Here are further facts.

What is the ICU (Intensive Care Unit)?
What is Different About the ICU Compared to Other Hospital Units?
Visiting Guidelines for the ICU
Why Are Patients Admitted to the ICU?
What Can I Expect as a Patient or as a Family Member of a Patient in the ICU?
What Are Advance Directives?
When Are Patients Transferred Out of the ICU?

What is the ICU (Intensive Care Unit)?

The Intensive Care Unit (ICU) is a unit in the hospital where seriously ill patients are cared for by specially trained staff. The ICU staff includes doctors, nurses, respiratory therapists, clinical nurse specialists, pharmacists, physical therapists, nurse practitioners, physician assistants, dietitians, social workers, and chaplains.

What is Different About the ICU Compared to Other Hospital Units?
Care in the ICU differs from other hospital units.

•Seriously ill patients require close observation and monitoring. Specially trained nurses care for one or two patients at a time, each shift. ICU doctors are specially trained critical care doctors.

•Patients may have special equipment in their room, depending on their unique situation and condition. The equipment in the ICU may seem overwhelming. Patients are connected to machines to monitor their heart, blood pressure, and respiratory rate. Ventilators (breathing machines) assist some patients with breathing until they are able to breathe on their own.

Visiting Guidelines for the ICU

•We request that visitors be limited to two at one time for patients in the ICU. You are advised to stay inside the patient's room during your visit. If you are asked to wait outside of the patient room, please return to the waiting area out of respect for other patient's privacy.
•Visitors will be asked by the ICU staff to leave for short periods during doctor's rounds, nurses' report, certain procedures, and emergencies.
•Doctor's Rounds: Doctor's rounds usually occur during the morning, early evening, and at midnight. Due to patient privacy issues and the close proximity of our patient rooms to each other, visitors will be asked to leave the unit occasionally when doctor's are rounding on their patients or the patients on either side of the patient they are visiting. Visiting may resume once the team is at least two doors away from the patient.
•Visitors are asked not to visit when they have potentially infectious conditions (for example: respiratory infections – "colds").

Why Are Patients Admitted to the ICU?
Patients are admitted to the ICU for a variety of reasons. Some patients need close monitoring immediately after a major surgical operation or serious head injury. Others may have problems with their lungs that require ventilator support with breathing. Patients may have heart and blood vessel problems (for example, very low or very high blood pressure, a heart attack, or an unstable heart rhythm) needing observation. Patients in the ICU may have an imbalance in the level of chemicals, salts, or minerals in their bloodstream that require close monitoring as these levels are corrected. Also, patients may have a serious infection in their bodies that require specialized ICU care.

What Can I Expect as a Patient or as a Family Member of a Patient in the ICU?
You can expect that the ICU staff will keep you well-informed of any major changes in the patient’s condition or procedures that are being performed. You can expect to speak with a doctor on a regular basis. Members of the ICU team meet with the patient and/or family to ensure that everyone has a common understanding of the health condition and the plan of care. During these meetings, it is a good time for family members to ask any questions of the health care team.
It is important to understand that even though modern medicine has come a long way over the past 30 years, not all diseases can be treated or cured. Patients may be transferred to the ICU because there is a chance they may die without intensive care treatment. And sometimes, despite the use of specially trained staff and advanced technology, doctors may not be able to reverse the dying process.
Because patients in the ICU may be critically ill, they may be unable to speak on their own behalf. In this case, the doctors and nurses may ask the family what the patient would want done in the event that their heart or lungs fail. There are times when the doctors may recommend against the use of life support machines and treatments.

What Are Advance Directives?
Making decisions about the end of life can be very difficult. Often, decisions about end-of-life care are delayed until patients become very sick – too sick to make treatment decisions on their own. An Advance Directive (also called "health care proxy" or "living will") is a written statement completed in advance of a serious illness that states patients' wishes about their medical care. An Advance Directive allows patients to state what medical treatment choices they want or do not want if they become too sick to tell the doctor themselves. One kind of Advance Directive under California law allows patients to select and name a person or "agent" who can make health care decisions on their behalf in the event that they are unable to speak for themselves. This legal document is called a "Durable Power of Attorney for Health Care." You may wish to speak with your family, close friends, or your doctor about your decision to complete an Advance Directive. Please ask the staff if you need further information on either an Advance Directive or a Durable Power of Attorney for Health Care.
If you already have an Advance Directive, it is important to give a copy of that document to the hospital staff so that it can be kept in your medical record.

When Are Patients Transferred Out of the ICU?
Some people may think that staying in the ICU for a longer period of time is better than moving to another hospital unit. However, the ICU is designed to care for only seriously ill patients. So, when a patient is improving and moving towards recovery, he/she will be transferred to the next level of care that meets his/her individual medical needs.

What is the most important duty and responsibility of a nurse?

It is to follow instructions of a medical doctor within the medical field except if it harms others. Ask yourself these questions.

Will this harm anyone?
Will anyone object to this?
Who instructed you to do this?
How many nurses work in this hospital?
What does the scrub nurse/technician do?
What does the circulating nurse do?

Intensive care unit management.

What should be the nurse-patient ratio in an intensive care unit setting?
1:1

How many total beds are there in the intensive care unit?
12, 24.

How many nurses, nursing assistants, and sanitary assistants?
Forty nurses, 20 nursing assistants, and two sanitary attendants for its 12 beds.

What is the total staff required for the intensive care unit?

What other staff is required for the intensive care?

Procurement staff, nursing assistants, sanitary attendants.

What is the difference in the duties and responsibilities of an intensive care medical doctor and an intensive care nurse?

What problems may nurses face during working hours?
Excessive workload, stressful working conditions, uncooperative patients, and odd working hours.

What should nurses do if they are induced to come for an outing after working hours?
They must refuse.

What should nurses do if they face harassment from their colleagues?
Report to administration.

What if administration is involved in maliciously engineering these activities?
Protest. Call for protests.

What should others do if they find out nurses have been harassed?
File verbal and written complaints, and protest.

What should be the nurse-patient ratio?
The ideal being 1:3.

Who had the duty and responsibility to resolve nurses’ issues: medical doctor, hospital administration, or the state administration?

People get involved in these issues, without knowing these questions, without having answers to these questions, while getting remuneration money from various sources. Is it justified?

What is the curriculum?
How long is it going to take?
What are Nurse Practitioners (NPs)?
What is the history of the NP role?
Where do NPs practice?
How cost-effective are nurse practitioners?
How are NPs different from Physician Assistants (PAs)?
How Can I Become a Nurse?
    ADVANCED PRACTICE NURSING
    AMBULATORY CARE NURSING
    CARDIAC CARE NURSING
    CARDIAC CATH LAB NURSING
    CASE MANAGEMENT NURSING
    CERTIFIED REGISTERED NURSE ANESTHESIA
    CLINICAL NURSE SPECIALIST
    COMMUNITY HEALTH NURSING
    COMPLEMENTARY HEALTH NURSING
    CORRECTIONAL FACILITY NURSING
    CRITICAL CARE NURSING
    DERMATOLOGY NURSING
    DEVELOPMENTAL DISABILITY NURSING
    DIABETES NURSING
    EMERGENCY NURSING
    ETHICS IN NURSING
    FAMILY NURSE PRACTITIONER
    FLIGHT/TRANSPORT NURSING
    FORENSIC NURSING
    GASTROENTEROLOGY NURSING
    GERIATRIC/GERONTOLOGICAL NURSING
    GERONTOLOGICAL NURSE PRACTITIONER
    GYNECOLOGY/OBSTETRIC NURSING
    HEALTH POLICY NURSING
    HEMATOLOGY NURSING
    HIV/AIDS NURSING
    HOLISTIC NURSING
    HOME HEALTH CARE NURSING
    HOSPICE/PALLIATIVE NURSING
    INDEPENDENT NURSE CONTRACTING
    INFECTION CONTROL NURSING
    INFORMATICS NURSING
    INFUSION NURSING
    INTERNATIONAL NURSING
    LABOR & DELIVERY NURSING
    LONG-TERM CARE NURSING
    MANAGED CARE NURSING
    MEDICAL-SURGICAL NURSING
    MILITARY AND UNIFORMED SERVICE NURSING
    MISSIONARY NURSING
    NEONATAL INTENSIVE CARE NURSING
    NEPHROLOGY NURSING
    NEUROSCIENCE NURSING
    NURSE ATTORNEY
    NURSE EDUCATOR
    NURSE LIFE CARE PLANNING
    NURSE MIDWIFERY
    NURSE PRACTITIONER
    NURSING QUALITY IMPROVEMENT OCCUPATIONAL HEALTH NURSING
    ONCOLOGY NURSING (CANCER NURSING)
    OPERATING ROOM NURSING (PERIOPERATIVE NURSING)
    OPHTHALMIC NURSING
    ORTHOPAEDIC NURSING
    OTORHINOLARYNGOLOGY NURSING (HEAD AND NECK NURSING)
    PAIN MANAGEMENT NURSING
    PARISH NURSING
    PEDIATRIC ENDOCRINOLOGY NURSING
    PEDIATRIC NURSE PRACTITIONER
    PEDIATRIC NURSING
    PERIANESTHESIA NURSING (RECOVERY ROOM NURSING)
    PERINATAL NURSING
    PLASTIC SURGERY NURSING
    POISON INFORMATION SPECIALIST
    PSYCHIATRIC NURSE PRACTITIONER
    PSYCHIATRIC NURSING
    PUBLIC HEALTH NURSING
    PULMONARY CARE NURSING (RESPIRATORY NURSING)
    RADIOLOGY NURSING
    REHABILITATION NURSING
    REPRODUCTIVE NURSING
    RHEUMATOLOGY NURSING
    SCHOOL NURSING
    SUB-ACUTE NURSING
    SUBSTANCE ABUSE NURSING
    SUPPLEMENTAL/AGENCY NURSING
    SURGICAL NURSING
    TELEMETRY NURSING
    TELEPHONE TRIAGE NURSING
    TOXICOLOGY NURSING
    TRANSCULTURAL NURSING
    TRANSPLANT NURSING
    UROLOGIC NURSING
    WOUND & OSTOMY NURSING
    TRAUMA NURSING
What is nursing?

Who are nurse practitioners and what do they do?

What is the nursing shortage and why does it exist?

What are problems thwarting nursing recruitment and retention?

Are you sure nurses are autonomous?

What is Magnet status?

How many nurses are there? How old are they? Do they outnumber physicians?

How is nurse migration affecting nurses and the nursing shortage?


The value of nursing

What happens to patients when nurses are short-staffed?

Do physicians deliver better care than Advanced Practice Nurses?

.

The media's effect on nursing and what can be done about it

Come on. Even if the mass media does ignore nursing, or present it inaccurately, how can that possibly affect nursing in real life? answer...

OK, fine. I can see that some media probably affects how people think about and act toward nursing, like maybe a respected newspaper or current affairs show on TV. But how can some TV drama, sitcom or commercial affect people that way? People know enough not to take that stuff seriously! answer...

I get that the public health community and even Hollywood itself believes that the entertainment media has a big effect on real world health. But is there any actual research showing it affects what people think and do about health issues like nursing? answer...

Well, if all that research shows how influential Hollywood is on health care--and Hollywood itself claims credit for improving the world through "medical accuracy"--why won't it admit that its portrayal of nursing is equally influential, and take steps to fix it? Especially since the nursing shortage is now a global public health crisis. answer...

What is the problem with the naughty nurse stereotype? I mean, no one believes that nurses really dress like that! answer...

But I'm young and hot and I love people to think nurses are sexy! Promiscuous girls rule! Anyone who objects to the "naughty nurse" image must be an old hag "nursing leader" who hates sex and freedom, right? answer...

But that television show you're complaining about just happens to be about physicians. How can you expect it to show nurses or nursing? answer...

Nurses are just wonderful, but you really can't expect Hollywood to focus on them, can you? After all, popular media products have to be dramatic and exciting. Why don't you just focus on getting a nursing documentary on PBS or basic cable? answer...

Is the world flat? Read the Center's early 2005 op-ed about addressing the nursing shortage by confronting society's deeply held view--embodied in the mass media--that nurses are just peripheral physician subordinates. answer...

Should we create a Museum of Modern Nursing to show the world how vital, exciting, and technologically advanced nursing really is? answer...

The Center for Nursing Advocacy's work

You're always criticizing the mass media's treatment of nursing. But don't you think nursing itself and society as a whole bear some responsibility for poor understanding of nursing, and for the profession's problems generally? answer...

Why aren't you more excited that public opinion polls often put nurses at the top of the list of "most trusted" and "most ethical" professions? answer...

You're always asking the media to change what it's doing, or even to withdraw a media product completely. Don't you think people have a right to say whatever they want? You act like the speech police! answer...

Why are you so darn critical of everything the media says about nursing? Don't you know that you catch more flies with honey than vinegar, that if you can't say something nice you shouldn't say anything at all, and that sugar and spice and everything nice, that's what little nurses are made of? answer...

Does the Center for Nursing Advocacy have some issue with physicians? It seems like you sometimes minimize their role in health care, or criticize something a physician has said or done. answer...

Don't you want nurses to be compassionate? You seem uncomfortable when nurses are described that way, and you focus instead on nurses' training and skills. answer...

Why is some of the Center's media analysis informal, irreverent or satirical? It's pretty rare to see a serious advocacy group take that approach. answer...

You're critical of a lot of what the media does, but you also try to be fair even to media products that you think cause harm to nursing. Aren't advocacy groups supposed to argue that everything they dislike is pure evil? answer...

Why do the Center's media reviews discuss overall merit, not just nursing? answer...

Nurse-friendly language

What is nurse-friendly language and why is it important? answer...

Should we use the term "medicine" to refer to health care generally? answer...

"You could be a doctor!" counter-statement...

Are nurses angels of mercy? answer...

Should we refer to every non-physician caregiver as a "nurse" no matter what type or level of training that person has? answer...

Is it OK if we keep saying that only nurses who currently work at the bedside are "real nurses?" Demonizing everyone else helps us fight for workers' rights! answer...

Is nursing a subspecialty of medicine? answer...

Should we refer to physicians as "doctors?" answer...

OK, if I promise to say "physicians," not "doctors," may I go to the "physician's office?" May I "take my loved one to the physician?" answer...

Should we refer to physician care plans as "orders?" answer...

Should we refer to breastfeeding as "nursing?" answer...

You want a career in science? Then why are you applying to nursing school? answer...

Should we use the indefinite pronoun "she" to refer to nurses, since most nurses are female? answer...

New ways to think about nursing

Do physicians help nurses improve health? AKA: Are physicians nurses' assistants? answer...

Why do you call for more discussion of nursing errors and nursing malpractice in the mainstream media? Suggestions for Nurses Having Problems in the Workplace

Problems in the workplace? some general suggestions...

Sexually harassed by your patients? one solution...

What is physician disruptive behavior and why does it exist? answers...

Q: What is nursing administration?

Q: What types of positions do M.S. graduates in nursing administration secure?

Q: What is the salary range for nurse administrators?

Q: Does the UCSF curriculum meet the requirements for American Nurses Association certification in Nursing Administration?

Q: Is previous management experience necessary? on of the course work.

Q: Is it possible to do the program part time?

Q: What types of practical experiences are available as part of the program?

Q: Is the curriculum available on the Worldwide Web?

Q: Where can I learn more about nursing administration as a field of specialization?

Q: How do I know if a career in nursing administration is right for me?

If you're a trained nursing professional, you can afford to be a discriminating job seeker.

Part of the process of getting ready for an interview is knowing the questions you want to ask a potential employer. These questions should demonstrate your interest in the opportunity while helping you gauge whether the position is the right match for your skills, goals, personality and lifestyle.

Your inquiries should cover three main areas: orientation and training, the working environment, and the employer's management and administration. Orientation and Training

* What is the level and depth of orientation?

* Will more orientation time be granted if I feel I need it?

* Will my orientation take place during the shift I will be working?

* Is there a mentorship program?

* What are your expectations of new hires during their first six months on the job?

* Describe typical first-year assignments.

* What qualities do your most successful nurses possess?

Working Environment

* What is the nurse-to-patient ratio?

* How long are your shifts -- eight, 10 or 12 hours?

* How do you go about scheduling?

Is self-scheduling an option, or does someone else dictate the schedule?

* How long have most nurses been on the unit?

* Why did the last person in this position leave?

* How long has this position been vacant?

* Will I be on call if I accept this position? If so, what are the conditions/requirements of on-call duty?

Management and Administration

* How would you describe your management style? * How do you motivate employees?

* How do you demonstrate that you value your nursing staff?

* How much autonomy do you give your nurses to make decisions regarding patient care?

* How often do you conduct performance reviews? * Is the administration open to suggestions that would improve patient care?

* What challenges is this facility facing?

* What have been this unit's most notable successes and failures over the year?

* What are nurses' biggest challenges at this facility?

* What makes this facility unique among others in this region?

* What steps do you take to ensure safe working conditions?

* What are your plans for future growth?

* Why should I want to work here?

An Offer in Hand

Once you have the job offer -- and not before -- ask the standard questions about salary and benefits, such as:

* What is the salary?

* Is special compensation awarded for overtime? What is the differential for second-shift, third-shift and weekend work?

* What is the benefits package?

* Do you offer other incentives, such as paid journal subscriptions or scholarships for dependents?

* Do you provide financial support for continuing education?

* Are grants available for ongoing education?

* Are there special incentives for bilingual nurses?

* Is there room for advancement? What is the career path?

* How do you reward employees for exceptional work?

For all nurses seeking employment, here are some nurse interview questions that you could prepare yourself with. As with all interviews there is no substitute for preparation for an interview and we advise you to prepare your answers for each of these questions and write down a truthful, convincing answer. Some commonly asked nurse interview questions are listed below.

1. Tell us about yourself?

2. What do you know about this organization and why have you chosen to work here?

3. Why have you chosen to work as a nurse?

4. Why are you leaving the current job?

5. What are your career goals?

6. What was the high point and low point of your career so far?

7. What according to you are the qualities that a successful nurse must possess?

8. What do you expect your schedule to be in this job?

9. Describe your typical assignments at your old job?

10. What was the nurse-to-patient ratio in your previous assignment?

11. What was the length of your shifts?

12. How do you schedule your work normally?

13. Are you prepared to be on call if you are offered this position?

14. Are you aware of the challenges this facility is facing?

15. What according to you are the nurses’ biggest challenges at this facility?

16. What steps do you take to ensure safe working conditions?

17. What are your plans for future growth?

18. What is the salary that you expect?

19. What was the benefits package you were getting in your previous job?

20. Are you planning to pursue your higher education?

Anesthesia Nursing
Drug Guides Online
Emergency Nursing
Flight Nursing
1.Stick to the plan. Track all projects, deadlines, exams and other activities relating to work and/or school in a personal planner or a pocketbook calendar.

2.Take notes. Place notes in outline format with headers, subheads and bullet points. Add items your lecturer refers to in the book.

3.Create flashcards. A quick and easy way to quiz yourself right up until test day. Use flashcards for making a file of diseases/conditions and their treatments, listing signs and symptoms, diagnostic tests and interventions.

4.Tape record. This is especially handy on "test review" days when instructors share what material is likely to appear on the exam. Remember to check with your instructor first!

5.Compare notes. It's possible that your classmates have information you didn't catch and vice-versa.

6.Use the textbook to your advantage. Outline each chapter, write down questions about concepts you don't understand and refer to other resources for extra help (i.e. the Internet, nursing journals, NCLEX review materials, etc.).

7.Stay informed. Attending class is important. You never know if a question asked by a fellow classmate or a piece of information not found in the book might be found on the next exam.

8.Ask questions. Get answers to questions raised in your book, ideas you're unclear on from lectures or clarify your notes.

9.Stay in touch with your instructor. Visit during office hours, send an e-mail, talk by phone and sit in the front row during class whenever possible.

10.Be exam prepared. Find out what the exam will cover and the exam format. Review points emphasized in class, questions in your study guides, past quizzes and end of chapter review sections.

Do not get swayed by this advice, Be prepared for the exam.

What should a nursing student be aware of?

The NCLEX Examination passing score or a high score does not mean you can be a competent nurse in the real world.
Here are further guidelines.
Here are further guidelines.
Here are further guidelines.