December 30, 2008

The Qualities of Quality Critical Care

Trudy Nernberg, RN MN mixes a medication to be given during a code

Trudy Nernberg, RN MN mixes a medication to be given during a code.

A look at nursing in the ICU

Pointing toward her heart Trudy Nernberg, a critical care nurse at Grace Hospital for the past 15 years, says, "there is an intrinsic reward working in ICU."

Nernberg fondly remembers many patients she and the critical care team works with. She particularly remembered one patient she cared for in the Intensive Care Unit (ICU) about eight years ago. "He had a very bad respiratory problem and the outlook wasn't good," she recalls, but then with a joyful smile adds, "He still contacts our team regularly."

Teamwork is a crucial component to critical care nursing. The quality of care provided to critically ill patients and their families couldn't be accomplished without a team willing to work closely together and be dedicated to each individual within their care.

"We focus on each patient in their entirety," Nernberg says. "We look at every aspect of that person - not just the medical problem they were brought here with."

Nernberg says besides the traditional medical tests and information needed, the nurses and other staff within critical care work together to learn about a person's family life, past experiences and the community they live in to determine how to best help that individual.

"We learn details nurses would never know about a patient in other health care settings, and we learn how to piece those details together," Nernberg says.

Betty Lou Rock, Program Director for Critical Care in the Winnipeg health region agrees. "The critical care environment respects individuality, self determination and dignity of patients, and provides patients and their families with both compassion and realism," she says. "Research-based holistic care is part of the overall mission of critical care nursing."

Winnipeg Regional Health Authority's Critical Care Program serves the people of Manitoba, Northwestern Ontario and the Keewatin District of the Northwest Territories. It services 10 Intensive Care Units at six Winnipeg hospitals: two tertiary hospitals - Health Sciences Centre and St. Boniface General Hospital; and four community hospitals: Victoria General Hospital, Seven Oaks General Hospital, Concordia Hospital and Grace Hospital.

Each ICU unit consists of a team of nurses, doctors, pharmacists, respiratory therapists, dietitians, physiotherapists and support staff with critical care expertise providing 24-hour care for patients. Full teams of critical care staff support each other during hands-on activity with patients in the ICU such as mobilizing, repositioning, or dressing a patient in care. Each unit also provides a Code Blue response team to the rest of the hospital. These nurses spring into action to help with any medical emergency happening within the hospital (except the emergency department).

This cooperation and team approach is augmented with high quality educational programs for staff involved in providing critical care.

Rock recently completed the development of a program to meet both the education needs of new staff and existing staff, and create qualified nurses required to adequately staff the critical care beds in Winnipeg. The new Winnipeg Critical Care Nursing Education Program (WCCNEP) started its first group with 31 students on September 8, 2008.

"The program creates a learning environment to support the successful integration of practice and education," Rock says.

Now also a Critical Care Clinical Educator with WCCNEP, Nernberg divides her time instructing nurses undertaking the critical care program and as an educator on the floor in ICU, answering questions and research needs that arise from team members helping a patient.

"There is always something new to learn here," Nernberg says, adding that nurses interested in critical care need basically two prerequisites: six months to one year of nursing in any field, and a willingness to always be a learner. "You are going to learn every day, so be prepared. Even though I've been here 15 years and am now an educator, I still learn new things." That, she says, is one of the many qualities to enjoy about critical care.

Learn more about the Winnipeg Critical Care Nursing Education Program

- Kathryn McBurney


For more health and wellness news, pick up the Winter 2008/09 edition of Aspire, now available at selected WRHA offices and facilities.

Aspire is also available for download here:

Aspire - Winter 2008/09

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