Exploring the culture of an ICU. The imperative for facilitative leadership

This article presents findings of a study conducted in an Australian Intensive Care Unit (ICU). The authors were invited by staff of the unit to provide education to them to improve their experience of the workplace. Attempts to determine what staff would see as useful professional development activity, however, revealed an inability to specify their professional development needs. Exploration of the workplace situation with all nurses in the unit revealed that issues related to the workplace culture--the impact of a changing health care contexts on ICU nurses, a lack of collegial support, and a lack of preperation for the roles of ICU nurses--resulted in increased tension in the workplace and heightened job dissatisfaction. The article provides a discussion of these issues and suggests that while all who work in ICU are accountable for their interaction, those employed as educators have both a right and a responsibility to undertake a leadership role in the workplace. It is argued that the current role of educators in demonstrating procedures and equipment, assessing clinical competence of those new to the area, and supporting students who participate in accredited ICU training does not embrace the potential role of ICU educators to facilitate a change in unit culture and behavior.