DORUPA, LAILANI ROSE G. REPORT DRA.

RAMOS

SPECIAL MEDCAL NURSING CARE FOR OUT-PATIENT, EMERGENCY AND CRITICAL CARE OUT PATIENT

An outpatient nurse is responsible for the overall care of patients seeking treatment at an outpatient medical facility. At outpatient clinics, patients seek treatment and minor surgery for physical and mental illnesses, and injuries. It is the responsibility of an outpatient nurse to ensure the comfort of patients before, during and after medical procedures and surgery.

Initial Care

Patients placed in an outpatient medical facility must be under careful watch to ensure they are prepared for treatment and recovering adequately from medical procedures. An outpatient nurse observes patients on a regular basis and charts symptoms and progress. It is the responsibility of an outpatient nurse to report changes and concerns to physicians and specialists

Primary Duties

Outpatient nurses draw blood, check vital signs, monitor blood pressure, temperature and pulse, and ensure that IV lines are maintained. An outpatient nurse may also be required to assist with surgery, supplying physicians with needed surgical tools and instruments.

In many cases, patients do not stay overnight at outpatient clinics. Therefore, an outpatient nurse must ensure that a patient is prepared to recover at home. Before discharge, an outpatient nurse will check symptoms, administer medication and provide written precautions for patients. In addition, an outpatient nurse instructs patients and caretakers on how to take medication and perform minor medical procedures, such as in-home therapy for recovery.

Home Health Care

An outpatient nurse can work with patients in their homes. They ensure the patient is taking his or her medications, take pulse and blood pressure, and document the status of each patient assigned to them. Many of these RNs work for agencies that provide home health care.

Hospice Duty

RNs working with outpatients can be called on to help people who have decided to go home when they have been diagnosed with a terminal illness. Their duties include checking on the patient at assigned times or days, giving the patient medications to relieve pain and making the patient as comfortable as possible. The RN works closely with the doctor assigned to the patient and reports any concerns or medical problems found during visits.

Private Nursing

An RN can work for an individual as a private nurse. The RN serves this one patient every day for a set amount of time. The RN changes dressings, hands out medications and checks the patient's vital signs, as well as documents any medical findings to the doctor.

EMEERGENCY CARE One of the primary responsibilities of an emergency nurse is to provide care to patients when they need it the most. Such circumstances often get classified as emergency situations. Nurses trained in emergency nursing are able to meet the health care needs of the patients who are at a very critical stage of their illness.

Most nurses deal with on-the-spot situations or urgent calls made to them, in order for them to attend to patients. At the stage of the nurse attending to the patient, the reason for the illness or injury is not determined. This is because the doctor wouldn't have attended to the patient itself. Thus, the responsibility of the emergency nurse is to ensure she attends to the patient and provides him emergency healthcare treatment which can last until the time the doctor actually gets to deliver his treatment course. It is extremely important for the nurse to know how to take care of the illness or the injury condition of the patient. At the time of treating the patient, the nurse would try to understand the reason for the injury and will treat the patient in accordance with the reasons of the illness or the injury. This does not mean that the nurse has to be fully aware of the medical implications of the treatment. Her responsibility is to ensure that the patient, who is in an emergency situation, survives until the time the doctor gets to treat him CRITICAL CARE
Critical care nursing is the field of nursing with a focus on the utmost care of the critically ill or unstable patients. Critical care nurses can be found working in a wide variety of environments and specialties, such as emergency departments and the intensive care units.

Subspecialities of critical care nursing include such areas as Neonatal Intensive Care (or NICU, also called Nursery ICU), Pediatric Intensive Care (or PICU), and Adult Intensive Care (or ICU). The patient population of these units is generally based on the age of the patient.

ABOUT CRITICAL CARE NURSING

Definition of Critical Care Nursing

Critical care nursing is that specialty within nursing that deals specifically with human responses to life-threatening problems. A critical care nurse is a licensed professional nurse who is responsible for ensuring that acutely and critically ill patients and their families receive optimal care.
Definition of a Critically Ill Patient

Critically ill patients are defined as those patients who are at high risk for actual or potential lifethreatening health problems. The more critically ill the patient is, the more likely he or she is to be highly vulnerable, unstable and complex, thereby requiring intense and vigilant nursing care.

ABOUT CRITICAL CARE NURSING

Definition of Critical Care Nursing

Critical care nursing is that specialty within nursing that deals specifically with human responses to life-threatening problems. A critical care nurse is a licensed professional nurse who is responsible for ensuring that acutely and critically ill patients and their families receive optimal care.
Definition of a Critically Ill Patient

Critically ill patients are defined as those patients who are at high risk for actual or potential lifethreatening health problems. The more critically ill the patient is, the more likely he or she is to be highly vulnerable, unstable and complex, thereby requiring intense and vigilant nursing care.
Number of Critical Care Nurses in the United States

According to "The Registered Nurse Population" study conducted in March 2004 by the Department of Health and Human Services, there are 503,124 nurses in the U.S. who care for critically ill patients in a hospital setting. Of these, 229,914 spend at least half their time in an intensive care unit (ICU); 92,826 spend at least half their time in step-down or transitional care units; 117,637 spend at least half their time in emergency departments; and 62,747 spend at least half their time in post-operative recovery. Critical care nurses account for an estimated 37% of the total number of nurses who work in a hospital setting.

Where Critical Care Nurses Work

According to "The Registered Nurse Population" study, 56.2% of all nurses work in a hospital setting, and critical care nurses work wherever critically ill patients are found intensive care units, pediatric ICUs, neonatal ICUs, cardiac care units, cardiac catheter labs, telemetry units, progressive care units, emergency departments and recovery rooms. Increasingly, critical care nurses work in home healthcare, managed care organizations, nursing schools, outpatient surgery centers and clinics.
What Critical Care Nurses Do

Critical care nurses practice in settings where patients require complex assessment, highintensity therapies and interventions, and continuous nursing vigilance. Critical care nurses rely upon a specialized body of knowledge, skills and experience to provide care to patients and families and create environments that are healing, humane and caring. Foremost, the critical care nurse is a patient advocate. AACN defines advocacy as respecting and supporting the basic values, rights and beliefs of the critically ill patient. In this role, critical care nurses:

Respect and support the right of the patient or the patient's designated surrogate to autonomous informed decision making. Intervene when the best interest of the patient is in question. Help the patient obtain necessary care. Respect the values, beliefs and rights of the patient. Provide education and support to help the patient or the patient's designated surrogate make decisions. Represent the patient in accordance with the patient's choices. Support the decisions of the patient or designated surrogate, or transfer care to an equally qualified critical care nurse. Intercede for patients who cannot speak for themselves in situations that require immediate action. Monitor and safeguard the quality of care the patient receives. Act as a liaison between the patient, the patient's family and other healthcare professionals.

The Roles of Critical Care Nurses

Critical care nurses work in a wide variety of settings, filling many roles including bedside clinicians, nurse educators, nurse researchers, nurse managers, clinical nurse specialists and nurse practitioners. With the onset of managed care and the resulting migration of patients to alternative settings, critical care nurses are caring for patients who are more ill than ever before. Managed care has also fueled a growing demand for advanced practice nurses in the acute care setting. Advanced practice nurses are those who have received advanced education at the master's or doctoral level. In the critical care setting, they are most frequently clinical nurse specialists (CNS) or acute care nurse practitioners (ACNP). A CNS is an expert clinician in a particular specialty critical care in this case. The CNS is responsible for the identification, intervention and management of clinical problems to improve care for patients and families. They provide direct patient care, including assessing, diagnosing, planning and prescribing pharmacological and nonpharmacological treatment of health problems. ACNPs in the critical

care setting focus on making clinical decisions related to complex patient care. Their activities include risk appraisal, interpretation of diagnostic tests and providing treatment, which may include prescribing medication.