Coronary care units care for hospitalized tenants with the most severe and life threatening illnesses and injuries. These patients require close monitoring, support and medication to sustain normal body functions. The Call staff consists of highly trained doctors and critical care nurses trained to care for critically ill patients. Aside from critical care responsibilities, ICC nurses are required to be knowledgeable with a wide variety of devices and monitoring equipment that is not typically used in other departments of the hospital.
ICC nurses may further their credentials and become CORN certified through the American Association of Critical Care Nurses (CAN). Becoming CORN certified validates the nurse’s knowledge of acutely and/or critically ill. The shift began with my choice of the patients that would assist caring for. I chose to work with the nurse that had the most critically ill patients. Report was given from the night shift nurse, and we immediately began working with the two patients assigned.
Care began with a full assessment of the patient to include a full set vitals and a head-to-toe assessment. This patient was admitted to the CALL following a myocardial infarction (at the patient’s home) where CPRM began approximately five minutes after the episode began. This led to extensive brain injury as evidenced by the CT scan, decelerate posturing, and overall flaccidity of the patient. The patient had been initiated in the E. D. Six days prior and it was still in place.
Essential care for initiated patients involves several evidence- based practices including team communication, ventilator settings and modes, appropriate suctioning, pain assessment and sedation, infection prevention, hemorrhagic monitoring, and airway management. Throughout the shift, I was able to provide this care along with skin assessments, qua positioning, monitoring l&O’s, medication administration, assessing labs, and harming. For this patient, an ethics meeting was planned to meet with the family to discuss the need of replacing the endothelial tube with a tracheotomy.
The family had high hopes that this patient would recover without the need of a tracheotomy. During the shift, was able to observe what is called “rounding. ” This is a scheduled time where the doctors, nurses, respiratory therapists, clinical nurse specialists, pharmacists, physical therapists, dieticians, and social workers all come to the Call to discuss the plan for each patient. There was a scribe person present taking detailed notes bout what was discussed. Mound this to extremely useful in my observation as it brings the team together to formulate a plan of action that involves the patients, the families, and the care staff. My experience in the Call was extremely motivating for me. Was able to ask many questions to the nurse and the charge nurse about the type of education and skills that I would need to purse a position in the CALL. The staff is extremely knowledgeable about the role that they serve. This observation experience has provided me with the insight to focus on the need to facilitate lifelong learning in my nursing profession.