The Development of Intensive Care Nursing as a Specialty at Wellington Hospital Intensive Care Unit, Wellington, New Zealand, 1964-1989

<p>Intensive care nursing developed as a specialty with the advent of intensive care units (ICUs) following the poliomyelitis outbreaks of the 1950s. In New Zealand (NZ) the first ICU was opened in the early 1960s in Auckland. Many ICUs were quickly established in other NZ hospitals around this time with Wellington Hospitals ICU opening in 1964. This work explores the first 25 years of the development of the Wellington ICU and the specialisation of ICU nursing. Oral history interviews with past and present staff who worked and taught in the ICU during this time and Hospital archives and primary documentation sources provided much of the background information about this development. One find during the cataloguing of materials and administrative records prior to the move to the newly built Wellington Regional Hospital was the patient admission records documenting each year of the unit‟s operation since it opened. The information gathered from these records provided data on patient demographics, giving age, admission diagnosis, discharge destination, mortality information and admission source for each patient admitted. Education of the nurses, many of whom were embracing the knowledge and technology required to look after ICU patients for the first time was paramount to the care of the critically ill patient. With the advent of an ICU six-month nursing course in 1968 many of the educational needs of the nurses were met. Working relationships with the medical staff were very different from those that many nurses had been used to when working in the wards with the Doctor - Nurse relationship becoming less formal and more collaborative. This thesis illustrates the hard work and determination of those early nurses to provide excellent and appropriate care and translate knowledge into practice in order to look after these critically ill patients.</p>

The Development of Intensive Care Nursing as a Specialty at Wellington Hospital Intensive Care Unit, Wellington, New Zealand, 1964-1989

<p>Intensive care nursing developed as a specialty with the advent of intensive care units (ICUs) following the poliomyelitis outbreaks of the 1950s. In New Zealand (NZ) the first ICU was opened in the early 1960s in Auckland. Many ICUs were quickly established in other NZ hospitals around this time with Wellington Hospitals ICU opening in 1964. This work explores the first 25 years of the development of the Wellington ICU and the specialisation of ICU nursing. Oral history interviews with past and present staff who worked and taught in the ICU during this time and Hospital archives and primary documentation sources provided much of the background information about this development. One find during the cataloguing of materials and administrative records prior to the move to the newly built Wellington Regional Hospital was the patient admission records documenting each year of the unit‟s operation since it opened. The information gathered from these records provided data on patient demographics, giving age, admission diagnosis, discharge destination, mortality information and admission source for each patient admitted. Education of the nurses, many of whom were embracing the knowledge and technology required to look after ICU patients for the first time was paramount to the care of the critically ill patient. With the advent of an ICU six-month nursing course in 1968 many of the educational needs of the nurses were met. Working relationships with the medical staff were very different from those that many nurses had been used to when working in the wards with the Doctor - Nurse relationship becoming less formal and more collaborative. This thesis illustrates the hard work and determination of those early nurses to provide excellent and appropriate care and translate knowledge into practice in order to look after these critically ill patients.</p>

The lived experiences of intensive care nursing students exposed to a new model of high-fidelity simulation training: a phenomenological study

Background In postgraduate intensive care nursing courses, high-fidelity simulation is useful to prepare students to guarantee safe and quality care of critically ill patients. Surprisingly, this issue has not attracted sufficient attention in the literature, and it is not clear whether the linear application of the traditional high-fidelity simulation method based on prebriefing, the simulation session and debriefing, can serve as empirical reference in postgraduate students’ education. The aim of this study was to investigate the lived experiences of postgraduate students receiving multiple exposures to an innovative high-fidelity simulation design based on Kolb’s Experiential Learning Theory. Methods A phenomenological study was conducted at an Italian University involving a purposive sample of 15 nursing students attending the postgraduate intensive care course. Audio-recorded face-to-face in-depth interviews were held by a researcher in a dedicated room complemented with non-verbal communication outlined in the field notes. Thematic analysis was used to analyse the transcribed data. Results Three themes and ten categories were derived from the data analysis. The themes included pragmatic learning experience, the emotional path, and confidence. Conclusions Multiple exposure to high-fidelity simulation was lived as a pragmatic learning experience enhancing the students’ ability to apply theory into practice. This novel approach also contributed to the transition from negative to positive feelings and improved students’ confidence about technical and non-technical skills when caring for a critically ill patient.

Delirium in adult patients in intensive care: nursing interventions

Background: Delirium is a neuropsychiatric syndrome of high incidence in the critically ill patient. It is characterised by changes in acute attention and cognition, has a multifactorial aetiology and has a negative impact on the patient's clinical situation and future quality of life. Prevention of delirium and early identification can reduce associated morbidity and mortality. Consequently, it is vital that intensive care unit (ICU) nurses perform targeted patient monitoring to identify acute cognitive changes. Objective: To identify nursing interventions directed at the prevention and management of delirium in adult patients in ICU. Method: A scoping review was undertaken based on the principles recommended by the Joanna Briggs Institute. Results: Seven studies were selected for inclusion. Non-pharmacological and pharmacological nursing interventions were identified. Conclusion: The interventions identified were predominantly aimed at the prevention of delirium. The training of nurses and wider clinical team in preventing and identifying this syndrome is crucial.