1. Job Summary
The post holder will work as part of a team to provide a safe, effective, efficient and caring environment for patients, relatives and caretakers. They will be responsible for the assessment, planning, implementation and evaluation of all the nursing care with direct supervision from senior staff.
2. Duties and Responsibilities of ICU nurse
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Assessment of nursing needs; develop, implement and evaluate nursing care to meet those needs. |
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Able to perform all the skills used in ICU. |
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Ensure that nursing procedures are carried out in accordance with ICU protocol and guidelines, and to make sure these procedures are evidence based. |
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Focus on the promotion of health and prevention of illness. |
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Store and administer drugs according to the policy. |
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Work as a cooperative member of the multidisciplinary team. |
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Act as team leader, and take charge of the ICU in the absence of the seniors and in night duties. |
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Have the knowledge of proper equipment handling and care. |
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Ensure that equipment or devices are properly stored after use. |
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Identify malfunctioning equipment or devices. |
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Should communicate about any concerns through systematic process (channel wise). |
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Be punctual, honest and humble, and maintain personal hygiene while in duty. |
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Be responsible for the continuous care of patients as a bedside nurse. |
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Discuss with multidisciplinary team about patient issues and concerns and address it. |
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Maintain patient confidentiality at all times. |
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Promote good relationships with patient, relatives, public, other care organizations and all members of the multidisciplinary care team. |
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Promote good communication skills written and verbally. |
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Be considerate regarding the social and economic status of the patient and also should be smart to communicate with patience and respect with family members of the patient. |
3. Clinical Role
3.1. At the beginning of shift, receive detailed handover of the assigned patient from previous shift nurse.
3.2. Perform head to toe assessment of the assigned patient.
3.3. Check and secure IV Lines, Central Venous Catheters, Arterial Lines, Foley Catheter, and Drains.
3.4. Check monitors, ventilator settings and alarm settings.
3.5. Check and label IV fluid sets, emergency as well as other medications.
3.6. Make nursing care plan for the shift.
3.7. Prepare, attend and participate in ICU consultant’s rounds and rounds of primary unit.
3.8. Follow management plan as formulated in the ICU rounds.
3.9. Provide nursing care to the patient as follows.
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Provide all the bedside nursing care (oral care, eye care, skin care, perineal care) and maintain hygiene of the patient as well as patient’s environment. |
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Record at least hourly vital signs and neurological status and fluid balance status. |
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Record ventilator parameters. |
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Ensure that patients receive proper medication, the correct dose according to the standards. If any confusion about dose, frequency, please clarify with on duty doctor. |
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Ensure patient is receiving feed as instructed (Enteral/Parenteral). |
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Identify patients who are at risk of complications due to nutritional status. |
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Monitor and maintain the blood glucose level as per protocol. |
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Apply the pressure sore prevention strategies like use of air mattress, changing position at least every two hourly or as per need. |
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Monitor patient’s fluid intake and output to detect emerging problems such as fluid and electrolyte imbalances. |
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Assess the muscle power, monitor physical activity and implement early mobilization protocol. |
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Assess the patients’ pain levels and sedation requirements. |
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Ensure that patient receives adequate sedation / analgesia as instructed. |
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Ensure that patient has Stress Ulcer Prophylaxis and DVT Prophylaxis. |
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Maintain sleep hygiene and sleep–awake cycle. |
1.1. Involve in other Specialists round/visit in ICU and convey to on duty doctor/ICU Consultant.
1.2. Follow nursing protocols strictly. Deviation from protocol will require written instruction from on duty doctor.
1.3. Ensure patient’s safety and follow safety precautions.
1.4. Monitor for any changes in cardiac, neurological and renal changes and immediately notify the changes to on duty doctor and manage accordingly.
1.5. Assist doctor with procedures such as bronchoscopy, endoscopy, endotracheal intubation, and elective cardioversion.
1.6. Applying all infection prevention techniques and steps and ensure that all doctors, nurses and any individual coming in contact with patient follows them.
1.7. Check and update Crash Cart, Airway Cart, Line Cart and equipments.
1.8. Check, clean and maintain equipment’s used in ICU, e.g., Defibrillator, ECG Machine, Echocardiography Machine, USG Machine, EEG machine, Dialysis machine etc.
1.9. Ensure that all events, vitals and ventilator parameters are documented properly and at regular intervals.
1.10. At the end of shift, ensure that documentation is complete and give complete handover of the patient, medications and equipment’s to the assigned nursing staff of next shift.
1.11. Be proactive and raise patient’s issues to the ICU Consultants.
1.12. Be an advocate for the patient and speak on behalf of the patient and MUST NOT remain silent doing only whatever she has been told to.
1.13. Update oneself with latest protocols, regimens and standards of care.
1.14. Attend the conferences, training programs and regular in-service educational activities.
1.15. Maintain accurate, clear and complete documentation.
1.16. Recording should be done as per the Daily Critical Care Nursing Sheet available in the institute and as per need of the patient.
1.17. While writing the nurses note, double writing, unnecessary spacing, scribbling should be avoided. In case of error, it should be cancelled with single line.
1.18. Maintain absolute confidentiality in respect of patient’s record, medical nursing and allied health professionals.
1.19. Be considerate regarding the social and financial issues of a patient and should inform to ICU consultant, primary unit and the management team.
1.20. Be able to make communication smartly with patients and their family members.
1.21. Follow all the care bundles and incorporate FAST HUGS BID.
4. Skills & Qualifications
4.1. Bachelor’s degree in Nursing/Proficiency Certificate Level in Nursing.
4.2. Registered Nurse (RN) license from Nepal Nursing Council.
4.3. CPR course certification.
4.4. Knowledge of medical terminology and pharmacology.
4.5. Excellent communication skills, critical thinking, and problem-solving.
4.6. Bio-medical equipment handling and care.
4.7. BASIC For Nurses course certification (Preferred).
4.8. Infection Control and Prevention Practices Implementation.
4.9. Quality Control and Patient Safety Practices Implementation.
Further readings:
1. Donelan, K., DesRoches, C. M., Guzikowski, S., Dittus, R. S., & Buerhaus, P. (2020). Physician and nurse practitioner roles in emergency, trauma, critical, and intensive care. Nursing outlook, 68(5), 591-600.
2. Fox, S., & Jeffrey, J. (1997). The role of the nurse with families of patients in ICU: the nurses' perspective. Canadian journal of cardiovascular nursing= Journal canadien en soins infirmiers cardio-vasculaires, 8(1), 17-23.
3. Chaboyer, W., Foster, M. M., Foster, M., & Kendall, E. (2004). The intensive care unit liaison nurse: towards a clear role description. Intensive and Critical Care Nursing, 20(2), 77-86.
4. El-Masri, M. M., & Fox-Wasylyshyn, S. M. (2007). Nurses’ roles with families: perceptions of ICU nurses. Intensive and Critical Care Nursing, 23(1), 43-50.
