Whether you are a well-seasoned nurse looking for a change of pace or a novice nurse making long-term career aspirations, nursing has plenty to offer you. Over the years the field of nursing has grown considerably. It is now much broader with many different types of specialties and patient care units. These patient care units can range from general medical-surgical units, to intermediate medical care units, and all the way to specialized critical care and intensive care units. Understanding all of these areas of nursing, departments, and units can be overwhelming, especially if you’re newer to the field. Here we’ll focus on the various types of critical care nursing available and understanding the differences between each.
Critical Care Nursing
We’ll first begin by understanding what critical care nursing is. This is a specialized area of nursing care in which the nurse provides care to severely injured or severely ill patients. This type of care can occur in various settings. For example, when a patient presents to the emergency department via the ambulance and is diagnosed with a STEMI, this patient is receiving critical care nursing. Likewise, a patient who is already admitted to an inpatient unit but is severely ill and perhaps located in the intensive care unit would also be considered to be receiving critical care nursing. You can therefore see the difference between critical care and intensive care nursing, with the former being more about the type of nursing care and skills needed and the latter being more about the physical location or unit name the patient is admitted to.
What is the meaning of ICU?
Alright, so what is the ICU? ICU stands for intensive care unit. The ICU is defined as an organized system that cares for the critically ill patients. Within the ICU specialized medical and nursing care is provided to patients, there is enhanced monitoring, and several methods are utilized to provide the body’s organs with full support to sustain life. It is important to note that these areas of medicine can become very specialized resulting in several different subsets of units. It is easiest to understand them all if you think of ICU as a big umbrella term with multiple, more specific, types underneath it such as CICU, MICU, PICU, NICU, and SICU. Let’s look at these in more detail.
The CICU medical abbreviation stands for cardiac intensive care unit. CICU means that critically ill adult patients who have serious cardiac health conditions are cared for on this type of unit. Patients on this type of unit may have diagnoses ranging from heart attack, heart failure, cardiac electrical rhythm disorders, sudden cardiac arrest, to cardiogenic shock. (This is only a brief list of patient types. In actuality, there are several more types of diagnoses that could be found on this type of unit).
The MICU medical abbreviation stands for medical intensive care unit. MICU patients are adult medical patients who are critically ill. This means these individuals do not have any surgical conditions or needs. Some examples of MICU patients include patients severely ill due to blood infections, gastrointestinal issues, or kidney, liver, or lung problems. Essentially, as long as the individual is critically ill and does not have a surgical need, but does have a need for a higher level of care than a general medical unit or intermediate care unit than the MICU may be the best place for the individual.
The SICU medical abbreviation stands for surgical intensive care unit. The patients cared for on this unit are also critically ill adults however, these individuals have a surgical component and need to their care.
PICU and NICU
Up until now all the units we’ve discussed focused around adults and their healthcare needs, but unfortunately, sometimes children and infants are critically ill too. Where do these patients go? Children and infants have their types of intensive care units separate from those of adults and include PICU and NICU. PICU defined is the pediatric intensive care unit. This unit cares for critically ill pediatric patients. The NICU is the neonatal intensive care unit. This unit is specifically designed for critically ill or premature newborns. The difference between NICU and PICU is that the NICU is even more specialized, serving a more specific population than the PICU.
Okay, now that we have a better idea about the different types of ICUs available for patients let’s take a closer look at who works in an ICU. When working with patients who are severely ill it truly does take a whole team approach to care for these individuals and get each person back to their full state of health. The team within the ICU is therefore made up of several individuals. Typically, the ICU team consists of an intensivist physician, clinical pharmacist, dietician, multiple respiratory therapists, and multiple besides staff nurses. Depending on each patient’s particular situation and needs other specialized disciplines may also be involved such as psychologists, social workers, occupational therapists, and physical therapists. ICUs need nurses with impeccable nursing skills. These individuals often have extensive training when first assigned to a unit. These nurses often also complete additional learning and certifications as critical care nurses which helps show their additional knowledge base and competence level for how to safely care for patients with very high medical needs.
Nurse: Patient Ratio
A very popular question regarding ICUs is how many patients does an ICU nurse have at one time? This can vary a bit depending on where the nurse is practicing. For example, in the United States, there are federally proposed nurse-to-patient ratios however, each individual state is able to set their own guidelines for these ratios. Currently the federally proposed guidelines recommend that the nurse-to-patient ratio should be 1:2 for ICUs.
So, let’s bring all of this information together now. You can see there are a multitude of nursing units available to work on in today’s nursing world. As a nurse, it is important to have a base understanding of each and what type of patients typically are seen on those units so you can best determine what the ideal unit is for yourself. Know that critical care nursing is about the type of care you are providing whereas ICU refers to specific locations and units in which patients are cared for. If you’re looking at working in the ICU there are tons of options available. As long as you take the time to familiarize yourself with the ICU medical terminology, you’ll be able to find the right location for yourself, and with some hard work and dedication you will be able to excel in this specialized area of nursing.