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We look at the skills of a Critical Care Nurse - Intensive Care Nurse - in ICU, how to get a nursing job in that area and potential career paths as Band 6 Senior Nurse and beyond.
22nd May 2013
A critical care nurse may also be called an intensive care nurse, and it is their job to provide constant monitoring and care for patients in a seriously ill or unstable condition.
The ICU Department
The department name is often shortened to ICU (intensive care unit) and refers to the ward in a hospital that offers mechanical intervention to support a person whose organs may not be functioning correctly. For example, someone who cannot breathe for themselves will be attached to a ventilator to ensure oxygen continues to be circulated around the lungs.
An ICU department also has the capability to monitor many bodily functions simultaneously, including heart rate, blood pressure & flow and body temperature. These indicators are closely monitored by the critical care nurse assigned to the bed in order to detect any deterioration in a patient’s condition. It is common that every ICU bed has at least one specialist nurse assigned to it, and each type of ICU requires different skills from the nurses working there. For example a PIC (paediatric intensive care) unit will cater for children under 16 yrs old and will often be staffed by specialist paediatric nurses with experience in intensive care.
Day to Day on an ICU
There will be several different types of patients admitted to ICU, but they typically fall into two categories. Emergency admissions include those suffering from stroke or heart attack, blood poisoning, organ failure or following a serious accident. Planned admissions will be arranged for patients following major surgery.
Most patients admitted to ICU will require fluids and medication by IV. Medications delivered by IV include painkillers, antibiotics and sedatives. Post-surgery patients often require drains that remove excess fluid or blood from the wound area, and these are normally removed after 2-3 days.
Once a patient’s condition has stabilised they will often be moved to a high dependency ward, which is one step down from ICU, or they may go to a general ward to continue their recovery. The factors that affect this decision are mostly related to the severity of the condition, age and physical fitness.
Levels of Nursing Care in ICU
In a report published in 2000 entitled “Comprehensive Critical Care”, the Department of Health defined four levels of care for those in ICU.
Patients whose needs can be met through normal ward care in an acute hospital.
Patients at risk of their condition deteriorating, or those recently relocated from higher levels of care, whose needs can be met on an acute ward with additional advice and support from the critical care team.
Patients requiring more detailed observation or intervention including support for a single failing organ system or post-operative care and those ‘stepping down’ from higher levels of care
Patients requiring advanced respiratory support alone or basic respiratory support together with support of at least two organ systems. This level includes all complex patients requiring support for multi-organ failure.
How to become an ICU Nurse
There is no specific nursing degree course for direct entry into ICU, and most nurses working in ICU studied adult or child nursing to either diploma or degree level. Many will have completed a placement in an intensive or high dependency setting and will base their decision to apply for an ITU post on those experiences.
There are sometimes ICU posts advertised that accept newly qualified nurses and will offer a preceptorship and supernumerary introduction period while you learn the department. These are usually Band 5 nurse jobs based in an NHS trust hospital, however there opportunities for critical care nursing jobs in the private sector. These positions are often vacant for longer, purely because of the preference by many newly qualified nurses for working in and finding jobs in the NHS. However the employers in this sector regularly offer excellent salaries and benefits packages, so it’s an opportunity to gain experience even if you plan to return to the NHS later in your career.
Career Progression as an ICU Nurse
When you have roughly 4 -5 years nursing experience in ICU, you may find you want to progress your career to Band 6 Charge Nurse or ICU Senior Nurse. These positions often come with the opportunity to train to be a mentor, do a masters course, or train in a specific ITU subject area such as Advanced Trauma Nursing. It’s not essential to have a specific number of years experience before applying to become a Band 6, but it’s generally accepted as roughly the right amount of time to gain the necessary experience.
What can I earn - what is the salary for an ICU nurse?
The pay for a band 5 Nurse will begin at £21,170 and there are currently 8 pay points before you reach the maximum amount. If you decide to move on to be a band 6 Nurse Specialist, this pay scale starts at £25,472 and has 9 pay points before the maximum level. (Figures correct at date of posting).
Private sector salaries will vary according to the employer, so check the job advert for details. There will also be benefits included with either an NHS or private sector role, and these will most likely be discussed at interview with you.
Interview with Dr Dave Barton, Dept Head of Nursing at Swansea University. He began his nursing career as an ICU Nurse.
For more information about Intensive Care Unit Nurse jobs go to this Government document “Comprehensive Critical Care”
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