A profile of European ICU nursing

To evaluate major similarities and major differences between Western European countries in intensive care unit (ICU) nurse staffing, education, training, responsibilities, and initiative.

A questionnaire was sent to Western European doctor members of the European Society of Intensive Care Medicine, to be passed on to the nurse-in-charge of their ICU.

156 completed questionnaires were analyzed: 49% were from university hospitals, 26% from university-affiliated hospitals, and 25% from community hospitals; 42% of the hospitals had more than 700 beds, 67% of the ICUs had between 6 and 12 beds, and 54% were mixed medical-surgical units. Among British units, 79% had more than three full-time nursing equivalents (FTE) per ICU bed, while in Sweden 75% of units had less than two FTE/ICU bed. University hospitals had more nursing staff per bed than community hospitals. As regards training, 33% of nurses followed a training course before starting work on the ICU and 64% after starting on the unit, and 85% had easy access to continuing education, particularly in the university hospitals. In an emergency, more than 70% of nurses regularly initiated oxygen administration, mask ventilation, or cardiac massage. In Sweden 100% of nurses and in Switzerland 91% of nurses regularly inserted peripheral intravenous catheters, but only 7% of German nurses did. No German nurses and only 12% of British nurses regularly performed arterial puncture, but in Sweden 75% of nurses regularly did.

Even though the number of participants were limited, our questionnaire revealed variations in nurse staffing patterns among European countries and in their systems of training and education. Nurse autonomy also varies widely between countries.