Caring in Crisis: An Oral History of Critical Care Nursing

By Jacqueline Zalumas | Go to book overview

I. The Evolution of Critical Care Nursing

Critical care nursing is a post- World War II phenomenon. Its development paralleled the rise of medical specialization and the rapid emergence of complex medical technology. According to N. M. Simon( 1980:2-3), the modern intensive care unit (ICU) concept owes its development to three major forces. First, the recovery room experience in the 1940s and 1950s has shown to medicine and nursing the advantage of intensive and continual surveillance, by nurses, of very ill patients. Second, the progressive patient care concept proposed by hospital planners determined that patients in hospitals would be grouped according to the amount and intensity of nursing care required, in facilities designed to meet their special needs. Third, an evolving complex technology that permitted more ambitious surgical procedures required increasingly complex postoperative surveillance and nursing care.

The direct antecedent of the intensive care unit was the postoperative recovery room, which came into common use in the 1950s. Prerequisite and concurrent developments included those as diverse as antiseptic surgery, X-ray, blood transfusion, the hypodermic needle and syringe, the ventilator, cardiopulmonary resuscitation, various types of anesthesia, and drugs for pain relief, immunization, and antibiotics ( Harmer and Henderson, 1955; Kalisch and Kalisch, 1986; Starr, 1982). Treatment of battle casualties during World War II and the Korean and Vietnam wars produced new surgical techniques and treatment and supported the growth of critical care nursing as a specialty. Factors as varied as the role of women in the military and the emergence of the helicopter for triage and evacuation of the wounded for treatment elsewhere further refined the role of the critical care nurse.

The post-World War II trend toward hospital staff employment for nurses coincided with the boom in hospital building precipitated by federal funds for hospital construction ( Melosh, 1982). Specialization continued within medicine, paralleling new technologies and developments in cardiac surgery and arteriography, such as the heart-lung machine. Chemothera-

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Caring in Crisis: An Oral History of Critical Care Nursing
Table of contents

Table of contents

  • Title Page iii
  • Contents ix
  • Acknowledgments xi
  • Introduction 1
  • I. the Evolution of Critical Care Nursing 20
  • 2- "High-Tech" Nursing: The Contemporary Critical Care Unit 48
  • 3- the Art and the Science Of Nursing Care: the Nurse and The Critically Ill Patient 89
  • 4 - The Ethical Dimensions Of Critical Care Nursing 141
  • 5. Critical Care Nurses Speak 184
  • Appendix 213
  • References 221
  • Index 233
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