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Critical care nurses are professionals who are highly skilled and knowledgeable in health care and are mainly involved in working at the critical care unit with the assistance of other health care members, providing holistic and optimum care.  The knowledge and skill attained by critical care nurses can be useful in various health areas including crisis intervention, promotion of health, restoration or rehabilitation, prevention and maintainance in the care of patients who are in critical conditions[1].  Studies have shown that, it is important for such nurses to maintain a high level of competence by going through continuous education programs and observing the rules of Nursing Code of Conduct which sets limit to the conduct required of nurses serving patients in critical conditions.

A transformation strategy for critical care has been established with the main aim of ensuring that nurses dealing with these areas improve their performance and quality in services requiring critical care.  It has been emphasized that investment should be made to improve the system of management, access and quality of the critical care department.  Professional workers who serve in the critical care are supposed to meet the core competencies and standards recognized by the Nursing Code of Conduct[2].  With intensive care being the most sensitive area in the hospital department, staff workers involved in this department are required to conduct themselves professionally and with integrity, to ensure that they win public confidence and trust.  A critical care nurse is supposed to show professional attributes that include values, skills, judgments, knowledge and positive beliefs among others.

Critical care in nursing has standards set, which reflect safe, competent and ethical care for the patient.  This standards are the basis upon which any nurse working in the critical care department should observe.  These standards are implied by the Nursing Code of Conduct which sets the limit requirement of conducts of the nurses.  Any nurse who breach the code may be answerable for unprofessional conduct or misconduct.

Standards of Practice

There are established standards of critical care nursing which describe the performance level that should be observed by nurses who are in the practice of critical care.  The major element of these standards is a consideration on the expectations of practice, the legislation and professional standards that are to be observed.  The standards of practice on the other hand provide guidelines on how nurses are supposed to conduct themselves while working.  It is required that nurses should be able to make the right judgments while faced with a dilemma that requires them to make decisions, in order to solve the problem[3].

Standards of practice for critical care nurses require that the nurse must perform his or her duty with the sole aim of realizing the wellbeing of a patient.  A nurse should ensure that patients are attended to with a lot of care and diligence and should avoid any form of treatment that would be experimentally on the patient.  Nurses should have the best skills required to handle the patients and should use such skills to the best interest of the patient.  It is also required that critical care nurses have positive attitudes while attending to patients in order to observe safe practices.

In the exercise of their judgment, it is required that critical care nurses should respect the autonomy of patients.  The values of medical profession require that, a patient has the right to decide on the method of treatment they want to go through, they can decide whether they wish to go through a surgery or not, or whether they prefer treatment through injection or through the use of oral medicine.  In critical care, a cancer patient may decide whether they prefer the use of radiotherapy or chemotherapy as a way of treatment.  Critical care nurses should ensure that patients are attended in the best of their interests, where professional rules allow.

The code of ethics require that critical care nurses should ensure that patients receiving treatment under their care are treated well by both the nurses and other health care support staff in the critical care unit.  A nurse in the critical care unit should not have any conflicts of interest while dealing with a patient, he or she should also ensure that any form of treatment, either given by the nurse or any other health care person is an appropriate treatment for the patient.  Where a critical care nurse disapproves any mode of treatment, they have a right to challenge such treatment under the professional rules of practice and the code of conduct[4].  For instance, a nurse a critical care nurse can object to an operation where it is deemed according to the circumstances that the patient is too weak to be operated.  Such opinion should be considered and respected where there is good evidence for the action.

The autonomy given to the patients should however be observed to certain limits.  For instance, a patient who requires to be treated in a non-medical manner cannot have his or her decision respected if the professional rules do not allow this.  Patients are also not allowed to ask for treatment that is not of any scientific value.  For instance, a patient who requires the prescription of Viagra may be considered under specific medical treatment, but a patient who asks for the same treatment to treat an elbow that is fractured simply has no scientific evidence to require for such treatment.

It is also a professional rule that patients are not supposed to require for treatment that does not rhyme with the purpose for the medicine and the medical profession.  These are treatments that are not accepted within the the medical practice boundary.  For example, this may happen where the patient requires for voluntary amputation or female circumcision.  In such cases, such requests will fail[5].

In the practice of critical care, nurses often face legal challenges when patients suffer damages under their care and it is alleged that the critical care nurse was negligent while handling patient.  In such situations, the professional code of conduct protects such critical care nurses while such misfortunes occur in the course of duty.  A critical care nurse has to show that he or she performed the critical care duty with diligence and integrity, and that the nurse observed the standards set under the Nursing Code of Conduct.  If the nurse is able to show that the condition of a patient was beyond their control, they are exempted from any responsibility for the death or damage suffered by the patient[6].

Conclusion

In the practice of critical care, nurses are faced with various challenges, this area being the most sensitive department which deals with patients that are in critical conditions.  In order to attain clinical effectiveness, critical care nurses should possess professional attributes required for practice which include skills, values, judgments, knowledge and positive beliefs among others.  Critical care nurses should observe the Nursing Code of Conduct to ensure that they are competent and are able win the trust and confidence of members of the public.  Nurses have the right to be protected under the professional rules of conduct, they should respect the autonomy of the patient where a decision made by the patient is logical and should also ensure that the best treatment is given to the patient.

References

  1. Bongard, S. (2004). Current Critical Care Diagnosis & Treatment. Published by McGraw-Hill Professional.
  2. Chadwick, R. (2006). Applied Ethics: Critical Concepts in Philosophy. Published by Taylor & Francis.
  3. Craven, R. (2006).  Fundamentals of Nursing: Human Health and Function.  Published Lippincott Williams & Wilkins.
  4. Driscoll, J. (2004). Practicing Clinical Supervision: A Reflective Approach. Published by Elsevier Health Sciences.
  5. Wear, S. (2003). Informed Consent: Patient Autonomy and Physician Beneficence Within Clinical Medicine.  New York: Published by Springer.
  6. Craven, R. (2006).  Fundamentals of Nursing: Human Health and Function.  Published                Lippincott Williams & Wilkins.
  7. Wear, S. (2003). Informed Consent: Patient Autonomy and Physician Beneficence Within  Clinical Medicine.  New York: Published by Springer.
  8. Bongard, S. (2004). Current Critical Care Diagnosis & Treatment. Published by McGraw-Hill Professional.
  9. Chadwick, R. (2006). Applied Ethics: Critical Concepts in Philosophy. Published by Taylor & Francis.
  10. Chadwick, R. (2006). Applied Ethics: Critical Concepts in Philosophy. Published by Taylor & Francis.
  11. Driscoll, J. (2004). Practicing Clinical Supervision: A Reflective Approach. Published by Elsevier Health Sciences.

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