Intellectual work of the critical care nurse: applications from a qualitative study

Worldwide shortages of critical care (CC) nurses have resulted in efforts targeted at understanding this unique area of nursing practice. This paper describes the findings of a qualitative study in which interviews with 17 CC nurses were conducted and provides insight into the support and continuing education required by both novice and experienced CC nurses. Analysis of the transcripts, field notes, memos and diagrams, and a comparison of the emerging categories to previous research, assisted in identifying several themes important to CC nursing practice. Within one of these themes, labelled 'intellectual work', four categories are described. 'Inquisitive mind', 'seeing the whole picture', 'ongoing vigilant assessment' and 'quick response' each provide evidence to support the need for adequate preparation and ongoing nurturing of CC nurses. Ensuring that educational opportunities for all CC nurses are focused on the development of sound clinical reasoning skills may result in a better prepared and more stable workforce, and optimal outcomes in patient care.