Critical Care Nursing Career Tips

optimal care to acutely and critically ill patients. Critically ill patients are patients who are at high risk for actual or potential life threatening health problems. These patients are highly vulnerable, unstable, and have complex healthcare needs that require vigilant and intense nursing care.

These types of nurses and nurse practitioners are essential in intensive care units (ICUs), including medical, surgical, pediatric and neonatal ICUs, cardiac care units, cardiac catheter labs, telemetry units, progressive care units, emergency departments, and recovery rooms. Critical care nurses are also part of medical evacuation and transport teams.

In the United States, most critical care nurses are registered nurses; because of the unpredictable nature of the patient population, licensed practical nurses (LPNs) and licensed vocational nurses (LVNs) rarely assume the primary care role in caring for critically ill patients.

Registered nurses can obtain certification in critical care nursing through the American Association of Critical Care Nurses (AACCN), an advisory board that sets and maintains standards for critical care nurses. This certification, known as the CCRN, describes the holder as a certified critical care nurse for adult, pediatric and neonatal patient populations.

Several subspecialties of this type of nursing can be found in units composed of similarly aged patients. These subspecialties are in the following areas:

• Neonatal Intensive Care Unit, also called Nursery ICU or NICU. The NICU’s patients are primarily newborn and premature infants who are cared for until they reach the gestational age of one month. After this period, their care will be assumed by the Pediatric Intensive Care unit.
• Pediatric Intensive Care Unit, or PICU. Here, the patients are about one month to eighteen years of age.
• Adult Intensive Care, or ICU, takes care of patients who are beyond eighteen.

There may, however, be deviations from the above setup, such as sending newborns who get admitted in the Emergency Department to the PICU, rather than the NICU. There may be rare cases where an adult patient with congenital heart disease will be admitted to the PICU, as their current treatment is a continuation of treatment they had been receiving from their physicians since they were children.

Care subspecialties may also be based on the type of disorder, disease or primary injury of the patient population. For example, the Adult Intensive Care Unit may have a specialized unit for trauma patients called the Adult Trauma Intensive Care Unit.

There is a variety of equipment used in the critical setting with which intensive care nurses need to be thoroughly familiar. These include hemodynamic and cardiac monitoring systems, mechanical ventilator therapy, intro-aortic balloon pumps, ventricular assist devices, continuous renal replacement equipment, and other advanced life support devices. All of these are at the critical care nurse’s disposal when providing medical intervention to the critically ill.

CME for Maintenance of Certification for Critical Care Medicine

All critical care medicine specialists need to renew their board certification, and they do so through the American Board of Internal Medicine’s MOC or Maintenance of Certification program. Like all other MOC programs, this program is designed to make sure that all medical professionals who are engaged in critical care medicine continually strive for professional excellence. Also, the MOC program helps to ensure patient safety and up to date treatment and patient management. As we all know, CME or continuing medical education plays an important role in any MOC program as it aids medical professionals in attaining the level of skills, knowledge and competency required for the maintenance of their certification.

There are three areas of the MOC program that critical care medicine professional must complete in order for him or her to maintain his or her certification. First is to take and pass the secure exam offered by the American Board of Internal Medicine. Second, earn a total of one hundred CME points in the self-evaluation of both practice performance and medical knowledge. The points must be earned within the 10-year MOC cycle. Lastly, you must be licensed to fully practice your profession and you must have a good professional standing; that means your license to practice critical care medicine must not be held in question within the 10-year cycle.

The Secure Exam

The critical care medicine Maintenance of Certification exam prepared and rendered by the American Board of Internal Medicine is designed to test your clinical judgment and knowledge on certain areas of medicine in which you are expected to be most competent. The set of questions in the test were created by a team of specialists in critical care medicine; both in the clinical area and in academics. Only those who are already in the sixth year of the 10-year cycle are allowed to apply for the test. This online examination is given twice a year; an exam can be scheduled during spring or fall. The only available exam date for 2011 is on the 9th of November; the deadline of reservation for the said exam is on the 15th of August 2011. Those who have learning disabilities but are nevertheless eligible to take the test are given testing accommodations; they are allowed to take the test for four days instead of one.

CME Credits

In order for one to complete the Maintenance of Certification program, he or she must complete a total of one hundred CME credits in self-evaluation. This area of the program is divided in to two: self-evaluation of medical knowledge and self-evaluation of practice performance. There are several knowledge modules that are provided by the American Board of Internal Medicine and each of which are worth 10 CME points. On the other hand, there are also Practice Improvement Modules directed on the assessment of one’s clinical practice. This aims to check your level of competence in critical care medicine. Each module is usually worth at least 20 CME points.