Critical Care
Student Nurse
Critical Care
Handbook
Year 2
WELCOME TO CRITICAL CARE
Aneurin Bevan University Health Board
We would like to welcome you to Critical Care, Aneurin Bevan University Health Board.
We endeavour to provide you with a flexible learning experience that is relevant to your
learning needs.
You will be supported by qualified mentors, allocated to you throughout your stay,
although you will also have the opportunity to work with a variety of qualified staff to
enable you to gain as much varied experience as possible. Please discuss with them any
problems or particular needs that you may have. In addition, you will be supported by
the your University Link Lecturer, the clinically based Practice Educator, and the student
nurse facilitation team.
Health Board Information:
Nevill Hall and the Royal Gwent Hospitals formulate the Critical Care Service provision in
Gwent.
Aneurin Bevan University Health Board serves a population of more than
600,000 in South East Wales through its two district general hospitals in Newport,
Abergavenny and its two local general hospitals in Ystrad Mynach and Ebbw Vale;
supported by a number of community hospitals, health centres and mental health and
learning disabilities.
Nevill Hall Hospital is a 430 bedded hospital within a picturesque setting in Abergavenny,
surrounded by the Black Mountains and Brecon Beacons and is known as the “Gateway
to Wales.” The Hospital covers a large geographical area so consequently has a variety
of medical, surgical and trauma admissions.
In contrast, the Royal Gwent Hospital, in the heart of the city of Newport, has
approximately 774 beds, providing a comprehensive range of services comprising
medical, surgical, trauma and orthopaedic services, ophthalmology and otolaryngology
for inpatients, day cases and outpatients comprised through medical/surgical and
trauma admissions.
The Critical Care Units:
At Nevill Hall, the unit is a combined ITU and HDU, comprising 8 beds. Whilst funding
provision is primarily for 6 ventilated beds and 2 high dependency beds, their occupancy
is flexible according to need. Therefore we do have provision to ventilate a 7th patient
when the need arises.
In contrast, the Royal Gwent has a total of 16 beds; 8 of these being intensive care, and
8 high dependency. Although, just like Nevill Hall the beds are managed flexibly to
accommodate more intensive care patients than high dependency and vice versa where
required.
In both units, the intensive care patients are categorised as level 3 patients and are
nursed on a one nurse to one patient ratio. The high dependency patients are
categorised as level 2 patients and are nursed on a 1 nurse to 2 patients’ ratio. Medical
support is provided by unit based Consultant Intensivist and anaesthetic teams as well
as surgical and medical teams.
© Critical Care Student Nurse Handbook ABUHB: Year 2 AK/DAH/SJM, updated 2015
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Critical care provision comprises continuous invasive monitoring, respiratory and
cardiovascular support as well as renal replacement therapy. Patients are admitted to
the unit with a diverse range of conditions requiring medical and surgical treatments;
vascular surgery, gastro-intestinal surgery, renal support, neurological monitoring,
trauma team support and surgery, support for multi-organ failure, sepsis and respiratory
conditions such as pneumonia, COPD and Adult Respiratory Distress Syndrome (ARDS)
etc. Consequently you will gain experience in caring for these patients who may be
conscious or unconscious as a result of their condition or because of administered
sedation.
Therefore in respect of these, the following monitoring systems and treatments are
applied within both units:

Close continuous monitoring of all vital signs via central venous and arterial lines

Respiratory monitoring via oxygen saturations and arterial/venous blood gas
analysis

Inotropic & cardiovascular drug support

Invasive & Non-Invasive ventilation

Continuous Renal Replacement Therapy / Haemofiltration

Cardiac Output monitoring (PiCCO)

Sepsis identification & treatment through the application of the Sepsis Six and
associated care bundles.
At Nevill Hall, paediatrics are occasionally admitted to stabilise their condition prior to
transfer to Paediatric Intensive Care at the University Hospital of Wales. On both units,
patients maybe admitted that require tertiary centre care such as specialist
neurosurgery. These patients are often admitted to the unit for stabilisation prior to
transfer to the appropriate specialist centre. You may therefore get the opportunity to
go with these patients on transfer.
Essentially you will see a variety of critically ill patients during your visit. However of
significant importance is that basic fundamental nursing care is central to all the
treatments we provide for these patients. Consequently the technology used to assist in
the monitoring and treatment does not distract our direction from the patient. In critical
care we pride ourselves on providing “total patient care.” This means that despite all the
electronic and technological devices you will be involved in providing good quality basic
nursing care such as providing for hygiene needs, pressure area care, wound dressings,
psychological needs, pain management and family involvement as well as assessment
and its associated interpretation, treatment planning and evaluation.
Please discuss with your mentor any specific requirements or learning needs that you
require such as visits to other departments affiliated with critical care such as Outreach,
Pain team etc.
© Critical Care Student Nurse Handbook ABUHB: Year 2 AK/DAH/SJM, updated 2015
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The Critical Care Team
The multidisciplinary team work closely with each other for the benefit of each critically
ill patient. All team members pride themselves on being dedicated to the provision of
quality evidence based care for these patients. Consequently they are all substantially
knowledgeable and experienced in their work and are always approachable and willing to
provide teaching and support where required.
Medical / Intensivist Staff
Dr. Jack Parry-Jones:
Dr.
Dr.
Dr.
Dr.
Dr.
Dr.
Dr.
Dr.
Dr.
Dr.
Dr.
Dr.
Dr.
Stephen Edwards
Andy Summors:
Mike Martin:
Rachel Rouse:
Ed Curtis:
Kate Stevens
Ami Jones
Nick Mason
Babu Muthuswamy
Christine Weaver
Eloise Dawe
Sara Cook
James Williams
Clinical Director Pan Gwent / Consultant Anaesthetist
(based at RGH)
Consultant Anaesthetist NHH
Consultant Anaesthetist NHH
Consultant Anaesthetist NHH
Consultant Anaesthetist NHH
Consultant Anaesthetist NHH
Consultant Anaesthetist NHH
Consultant Anaesthetist NHH
Consultant Anaesthetist RGH
Consultant Anaesthetist RGH
Consultant Anaesthetist RGH
Consultant Anaesthetist RGH
Consultant Anaesthetist RGH
Consultant Anaesthetist RGH
Senior Staff
Sally Copner:
Senior Nurse Manager, Critical Care Unit, Pan Gwent
Sandy Morris
Sister RGH
Deb Harris
Sister NHH
Chris Howells
Sister RGH
Alison Stevens
Sister NHH
Angharad Wiltshire Sister RGH
Rebekah White
Sister NHH
Tracey Rich
Sister RGH
Deputy Team Leaders
Claire Orford
Deb Chard
Jan Price
Claire Jones
Ceri O’Brien
Terry Griffiths
Tanya Weaving
Jane Silcox
Paul Taylor
Sue Pretlove
RGH
RGH
RGH
RGH
RGH
RGH
RGH
RGH
RGH
RGH
Jill MacCormac
Andrew Storey
Julie Byrne
Sarah Jones
Jamie Morgan
Lynette Catalinio
NHH
NHH
NHH
NHH
NHH
NHH
Nursing Staff
Within Critical Care, we pride ourselves as a team, who provide high quality research
based care, according to patient need. Consequently, learning and development is a
fundamental requirement for all staff in the unit. The nurses within the team have
different levels of experience and expertise, from an array of differing experiential
disciplines. They are all keen and willing to share their knowledge with you and support
your development and learning. So please feel free to ask questions as no question is
too difficult to answer!
© Critical Care Student Nurse Handbook ABUHB: Year 2 AK/DAH/SJM, updated 2015
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Critical Care Outreach Team
The Outreach team comprise critical care nurses who follow-up and review patients that
have been discharged from critical care; providing clinical support and education for
ward staff in caring for these dependent patients. They also provide a referral service,
visiting patients who may require admission to the critical care areas, with the aim of
supporting ward staff in their care until admission is possible, or for those not suitable or
appropriate for admission. Consequently, their role is essential in providing a supporting
network for critical care admissions and discharges. In addition they work some clinical
shifts on the unit
Sally Copner
Karen Lewis
Angela Downward
Mel James
Laura Bumpsteed
Rachel Oliver
Alisa Allen-Ridge
Rebecca Radford
Outreach
Outreach
Outreach
Outreach
Outreach
Outreach
Outreach
Outreach
Team Leader, Senior Nurse Critical Care
Practitioner/Deputy Team Leader NHH
Practitioner/Deputy Team Leader NHH
Practitioner NHH
Practitioner NHH
Practitioner/Deputy Team Leader RGH
Practitioner/Deputy Team Leader RGH
Practitioner/Deputy Team Leader RGH
You will be offered the opportunity to work with the Outreach Team.
Education & Teaching
We do have a small critical care library, with a variety of books located in both units.
Computer facilities for staff are provided with access to internet and intranet. Through
access to the intranet you can search Health Board Policies and procedures, online BNF,
NICE guidelines etc to support safe practice during your placement. There are also postgraduate libraries on both sites.
Unit teaching is predominantly “ad hoc” depending upon workload etc. However, any
formal teaching sessions are advertised in advance, so please make efforts to attend
these.
Working closely with your mentor and the patient(s) you will have the
opportunity to discuss with a variety of multi-disciplinary team members the care of the
patient(s). These will include discussing and observing physiotherapy assessment and
techniques; discussing with the dietician the individualised feeding plans for patients and
the observations required; discussing the patients care with the intensivist individually
whilst also participating in the grand round which is attended by multi-disciplinary team
members to incorporate total patient assessment and treatment planning; opportunities
to observe and discuss investigations performed in critical care such as bronchoscopy,
ECG, echocardiograms etc; discuss medicines with the pharmacist. The grand round
also embraces a teaching philosophy to assist in the development of all attendees.
We also run The Essentials for Nursing in Critical Care module in affiliation with the
University of South Wales. If you wish to attend any of these or other advertised
sessions please speak to Ali Kirton, Deb Harris NHH or Sandy Morris RGH.
This information pack also contains some critical care learning outcomes for you to
complete during your stay. However, they are not compulsory nor are they intended to
add to or replace your academic and practical outcomes, but rather as a guide to the
learning opportunities and skills you may observe or even in some cases be able to
practice under direct supervision during your placement. They will also act as a guide
for your mentor in their teaching you at the bedside. Consequently there is no required
skill level/competency, just suffice that you have observed or practised some of them
under direct supervision. This is then simply ticked in the relevant box, and you can add
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any reflective or important points as you wish to support your learning. These can then
be utilised as part of your development portfolio as evidence and mapped to your clinical
learning outcomes in the space provided.
The following contacts will be able to assist with your educational needs, so please don’t
hesitate to contact them.
Deb Harris, Sister / Student Facilitation Team Lead Critical Care NHH
Tel:01873 732177: Email: Deb.Harris@gwent.wales.nhs.uk
Sandy Morris, Sister / Student Facilitation Team Lead Critical Care RGH
Tel:01633 234179: Email: Sandy.Morris@gwent.wales.nhs.uk
Jan Price, Deputy Team Leader / Student Facilitation Critical Care RGH
Tel:01633 234179: Email: Sandy.Morris@gwent.wales.nhs.uk
Alison Kirton, Practice Educator for Critical Care (Nevill Hall & Royal Gwent)
Tel: NHH 01873 732174/RGH 01633 234178: Email Alison.Kirton@gwent.wales.nhs.uk
Anna Jones, Link Lecturer, School of Healthcare Sciences, Cardiff University
Tel: 02920 746696: Email JonesA23@cf.ac.uk
Cheryl Phillips, Link Lecturer, Faculty of Care Sciences, University of South Wales
Tel: 01443 483818: Email Cheryl.Phillips@southwales.ac.uk
© Critical Care Student Nurse Handbook ABUHB: Year 2 AK/DAH/SJM, updated 2015
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Mentors
You will be allocated a mentor to facilitate achievement of your objectives during your
placement. There are plenty of developmental opportunities available so please discuss
these with your mentor or the student facilitation team. We endeavour to ensure that
you work with your mentor for the minimum of 50% of your placement. However you
may find that you work with a few different members of staff, but whilst priority will be
given to ensuring you gain optimum time with your mentor, this practice gives you the
opportunity to gain varied experience.
All qualified mentors have completed the “Fitness for Practice” mentorship programme
supported by Cardiff University & University of South Wales. The guidelines set out
within this training programme provide equity of standards ensuring that all of our
mentors practise to the same high standards with your needs core to their role within
the critical care unit.
Shifts
If you need to make any off duty requested please can you inform us at the earliest
possible opportunity as this can impact on the allocation of appropriate mentors.
NHH: Early
07:30 – 15:20
RGH: Early
06:55-14:55
NHH: Late
12:40 - 20:30
RGH: Late
13:30 – 19:35
NHH: Long Day
07:30- 20:30
RGH Long Day
05:55- 19:35
NHH: Night
20:00 – 08:00
RGH Night
18:55 – 07:35
Contact Numbers
Critical Care Unit, Nevill Hall Hospital: 01873 732176 / 732177
Critical Care Unit, Royal Gwent Hospital: 01633 234179 / 01633 234181
We hope you enjoy your stay with us. If you have any queries please let me know.
Good Luck
Deb Harris & Sandy Morris
© Critical Care Student Nurse Handbook ABUHB: Year 2 AK/DAH/SJM, updated 2015
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Student Nurse Philosophy
Critical Care ABUHB
We Aim:
To provide a welcoming environment with a supportive & positive learning ethos
To recognise your individuality & treat you with respect as part of the team
To offer you the experience you require to meet your learning needs that you have
identified prior to this visit
To be flexible in meeting your needs should they change
To assist you to identify learning opportunities and enable you to take full advantage of
these
To provide you with effective mentorship, support and direction during your visit
through ensuring that you are supported by suitably qualified mentors for at least 50%
of your visit
To provide resources for your development during your visit; information that is
evidence based & appropriate to your learning
To offer you the opportunity to evaluate your visit and enable us to tailor our learning
environment within reason, to meet students needs
To create an ongoing, developing, educational opportunity for all students
© Critical Care Student Nurse Handbook ABUHB: Year 2 AK/DAH/SJM, updated 2015
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PERSONAL OBJECTIVES FOR CRITICAL CARE
OBJECTIVE
COMPETENCY (how will you achieve this?)
© Critical Care Student Nurse Handbook ABUHB: Year 2 AK/DAH/SJM, updated 2015
EVIDENCE OF LEARNING &
COMMENTS
MENTOR
SIGN
& DATE
9
CRITICAL CARE PLACEMENT LEARNING OUTCOMES
1. HEALTH & SAFETY
“Demonstrates an awareness of health & safety in critical care & under supervision demonstrates knowledge of measures to maintain safety during
care delivery to patients & others.”
KEY SKILL
COMPETENCY
Fire Safety in critical care
Fire exits; procedures for alert & evacuation; extinguishing equipment.
Fire policy
Bed area preparation / set
up
Equipment required; monitoring; importance/rationale of bed area
checks each shift; individualised alarm setting
Orientation to emergency
equipment
Locates emergency trolley; orientation to intubation equipment & drugs;
discusses use of defibrillator
Safe Manual Handling of
patients
Principles of manual handling in accordance with Trust/unit policies;
Assists under supervision in the use of equipment/adjuncts
Applies Infection Control
policies/procedures in
critical care
Handwashing; Cleaning & disinfection of equipment; principles of patient
isolation (barrier/reverse barrier)
Applies disposal of waste
policies/procedures in
critical care
Safe disposal of bodily fluids; decontamination of equipment; safe
disposal of potentially toxic substances
Safe storage of drugs:
Safe administration of drugs
Discusses the safe storage of drugs used in critical care
Discusses & observes practice in administering drugs using the correct &
safe procedures such as intravenous via infusion pumps, oral, etc
© Critical Care Student Nurse Handbook ABUHB: Year 2 AK/DAH/SJM, updated 2015
EVIDENCE OF LEARNING &
COMMENTS
MENTOR
SIGN
& DATE
10
2. RESPIRATORY CARE
“Demonstrates ability under supervision to assess respiratory function, apply knowledge & skill to deliver safe care.”
KEY SKILL
COMPETENCY
Respiratory assessment
Discusses with mentor, respiratory function in critically ill patients:
 What does the patient look like?
 Observation of respiratory pattern – rate, depth, symmetry
 Auscultation – What can be heard? Equal breath sounds?
 Basic blood gas analysis – normal values, saturations etc
Discusses with mentor basic concepts of respiratory failure – signs &
symptoms;
Respiratory failure – Type 1
& 11
Gains insight to care under
supervision for patients with
deteriorating respiratory
function
Discusses with mentor the principles of adult intubation in terms of:
Indications for; patient safety; equipment & drugs; procedure & nurses
role; post intubation care & observation
Gains insight into
respiratory support for
patients with compromised
respiratory function
Discusses with mentor the principles of non-invasive ventilation &
assists under supervision in patient care: Equipment used; patient care
& observations; safety alarms; decontamination of equipment
EVIDENCE OF LEARNING &
COMMENTS
MENTOR
SIGN
& DATE
*
*
Discusses with mentor the principles of invasive ventilation & assists
under supervision in patient care: Equipment used; ventilator settings &
alarms; patient care & observations; decontamination of equipment
Airway clearance techniques
Discusses with mentor the principles of safe suction in the intubated
patient; when & how, assembling the appropriate equipment &
protective clothing
Tracheostomy care
Discuss with mentor the basic principles of tracheostomy: The
indications for; related nursing care & observations; complications &
decannulation
Adult Extubation
Discusses with mentor the principles of extubation; its indications; safe
procedure; post extubation observations & nursing care
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*
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2. RESPIRATORY CARE
“Demonstrates ability under supervision to assess & observe respiratory function; apply knowledge & skill to deliver safe care.”
KEY SKILL
COMPETENCY
Chest Drains
Discusses with mentor the basic principles’ of intercostal chest drainage;
pnemothorax/haemothorax; the related nursing care & observations.
EVIDENCE OF LEARNING &
COMMENTS
MENTOR
SIGN
& DATE
3. CARDIOVASCULAR CARE
“Demonstrates ability under supervision to assess & observe cardiovascular function; apply knowledge & skill to deliver safe care.”
KEY SKILL
COMPETENCY
Cardiovascular assessment
Discusses with mentor, assessment of cardiovascular function;
 What does the patient look like?
 Observation & interpretation of vital signs – pulse-rhythm, regularity
etc; blood pressure; capillary refill; temperature
 How does the patient feel? Peripheral circulation; skin temp; pulse
strength
 Medical history / drug history
Vital sign recording
Discusses & observes mentor in the recording of vital signs; discuss the
interpretation of trend values & related care & treatment
Basic Rhythm recognition
Discusses with mentor the components of normal sinus rhythm &
arrhythmias, & associated treatment
Arterial Line Care
Discusses & observes with mentor the basic principles & safety of
arterial pressure monitoring & blood sampling.
Central Venous Pressure
(CVP) line care
Discusses & observes with mentor the basic principles & safety of
central venous pressure monitoring.
© Critical Care Student Nurse Handbook ABUHB: Year 2 AK/DAH/SJM, updated 2015
EVIDENCE OF LEARNING &
COMMENTS
MENTOR
SIGN
& DATE
12
3. CARDIOVASCULAR CARE
“Demonstrates ability under supervision to assess & observe cardiovascular function; apply knowledge & skill to deliver safe care.”
KEY SKILL
COMPETENCY
Cardiac Output monitoring
Discusses & observes with mentor the basic principles & safety of PiCCO
Cardiovascular drug support
Discusses with mentor the use of the following cardiovascular support
therapy in critically ill patients:
 Inotrope / sympathomimetic drugs
 Anti-hypertensive drugs
 Anti-arrhythmic drugs
EVIDENCE OF LEARNING &
COMMENTS
MENTOR
SIGN
& DATE
4. FLUID MANAGEMENT
“Demonstrates ability under supervision to assess & observe fluid balance; apply knowledge & skill to deliver safe care.”
KEY SKILL
COMPETENCY
Fluid Management
assessment
Discusses with mentor the assessment of fluid balance:
 What does the patient look like?
 Observation & interpretation of vital signs in relation to abnormal
fluid balance – pulse/rhythm/regularity; blood pressure; capillary
refill; temperature
 How does the patient feel? Peripheral circulation; skin temperature;
pulse strength etc
 Medical history / drug history that may affect kidney function?
 Fluid intake – type / route of administration etc
 Fluid output/loss – type, sites such as wounds, skin puncture sites,
drains etc Discusses & observes practice with mentor accurate fluid
balance monitoring & its importance/significance
Discusses & observes practice with mentor accurate fluid balance
monitoring & its importance/significance
Fluid Balance recording
© Critical Care Student Nurse Handbook ABUHB: Year 2 AK/DAH/SJM, updated 2015
EVIDENCE OF LEARNING &
COMMENTS
MENTOR
SIGN
& DATE
13
5. BLOOD RESULTS
“Demonstrates ability under supervision to assess & interpret blood results.”
KEY SKILL
COMPETENCY
Blood sampling & blood
chemistry
Discusses & observes safe practice with mentor the following: blood
sampling via arterial line; normal values; safe transporting samples for
analysis
EVIDENCE OF LEARNING &
COMMENTS
MENTOR
SIGN
& DATE
EVIDENCE OF LEARNING &
COMMENTS
MENTOR
SIGN
& DATE
6. SHOCK
“Demonstrates ability under supervision to identify the basic signs of shock.”
KEY SKILL
COMPETENCY
Assessment of the shocked
patient
Discusses with supervisor the assessment of the shocked patients terms
of:
 What does the patient look like?
 Observation & interpretation of vital signs & capillary refill
 How does the patient feel? Skin temperature; Peripheral circulation;
pulse strength
 Medical history
 Fluid intake & loss
 Blood results – WBC/blood cultures
Care of the septic patient
Discusses with mentor the use of sepsis care bundle in the treatment of
critically ill patient; fluid management etc
© Critical Care Student Nurse Handbook ABUHB: Year 2 AK/DAH/SJM, updated 2015
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7. ELIMINATION
“Demonstrates ability under supervision to assess & observe elimination function; apply knowledge & skill to deliver safe care.”
KEY SKILL
COMPETENCY
Assessment of renal
function in critically ill
patients
Discusses with supervisor the assessment of the renal system in terms
of:
 What does the patient look like? Presence of oedema etc
 Observation & interpretation of vital signs & capillary refill
 Medical history / drug history that may affect renal function
 Urine output/losses such as wounds, puncture sites etc
 Blood results – urea, creatinine
 Urine analysis
Discusses with mentor indications for, insertion etc for a urinary
catheter. Observes practice/practices under supervision evidence based
catheter care
Catheter care
Renal Support therapies
Discusses with mentor renal failure, its identification & treatment; use of
fluid resuscitation to restore renal perfusion; Basic principles’ of renal
replacement therapy (Haemofiltration)
Assessment of gastrointestinal status in critically
ill patients
Discusses with mentor the assessment of patients GI status in terms of:
 What does the patient look like?
 Observation & interpretation of vital signs
 Medical history / drug history that may affect the functioning of the
GI tract?
 Bowel function – amount/presentation
 Presence of bowel sounds / paralytic ileus etc
 Serum chemistry – liver function tests etc
© Critical Care Student Nurse Handbook ABUHB: Year 2 AK/DAH/SJM, updated 2015
EVIDENCE OF LEARNING &
COMMENTS
MENTOR
SIGN
& DATE
15
8. NUTRITION
“Demonstrates ability under supervision to assess nutritional status; apply knowledge & skill to deliver safe care.”
KEY SKILL
COMPETENCY
Nutritional management
Discusses with mentor the basic principles of digestion/absorption of
nutrients; how this is assessed using MUST tool; nutrition administration
& monitoring via Nasogastric/PEG feeding & TPN
administration/monitoring
Blood glucose monitoring
Discusses with mentor the basic principles of tight glycaemic control in
critically ill patients; care & monitoring of patients receiving insulin;
recognition & treatment of hyper/hypoglycaemia
EVIDENCE OF LEARNING &
COMMENTS
MENTOR
SIGN
& DATE
10. SKIN INTEGRITY
“Demonstrates ability under supervision to assess skin integrity & wound healing; apply knowledge & skill to deliver safe care.”
KEY SKILL
COMPETENCY
Assessment of the skin
Discusses with mentor the importance & practice of skin assessment for
the presence of pressure damage, deterioration, wounds, drain sites, IV
puncture sites etc in terms of:
 Appearance – what does it look like? Wound / pressure mark size?
 Degrees / grades of damage
 Amount of exudate / leakage / drains etc
 Presence of infection / erythema / slough / necrotic tissue etc
Discusses with the mentor the application of the skin bundle to critical
care patients
Related nursing care
EVIDENCE OF LEARNING &
COMMENTS
MENTOR
SIGN
& DATE
Discusses & observes practice with mentor skin care in terms of:
 Pressure relief / support surfaces & mattresses
 Hygiene
 Care of IV insertion sites / monitoring in accordance with Trust policy
 Wound care / products
© Critical Care Student Nurse Handbook ABUHB: Year 2 AK/DAH/SJM, updated 2015
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11. PAIN MANAGEMENT & NEUROLOGICAL CARE
“Demonstrates ability under supervision to assess neurological function; apply knowledge & skill to deliver safe care.”
KEY SKILL
COMPETENCY
Neurological assessment
Discusses & observes practice with mentor the assessment of
neurological function utilising CAVPU & Glasgow coma scale; effecting
care/monitoring appropriately
Pain Management
Discusses with mentor the various analgesics available for critically ill
patients, their methods of administration & their subsequent monitoring
/ side effects etc
Sedating the critically ill
patient
Discusses with mentor the use & effects of sedatives used in critical
care; assessment tools; administration & monitoring / side effects
Caring for the
unconscious/head injured
patient
Observes and discusses with mentor the care of the unconscious
patient.
EVIDENCE OF LEARNING &
COMMENTS
MENTOR
SIGN
& DATE
12. POST-OPERATIVE CARE
“Demonstrates ability under supervision to care for patients post-operatively; applying knowledge & skill to deliver safe care.”
KEY SKILL
COMPETENCY
Post-operative care
Discusses with mentor, the admission of post-operative patients in
terms of:
 Observations & monitoring
 Comfort & pain relief
 Wounds & drains
 Fluid balance / recording
 Adverse changes / deterioration
 Communication / handover / documentation
© Critical Care Student Nurse Handbook ABUHB: Year 2 AK/DAH/SJM, updated 2015
EVIDENCE OF LEARNING &
COMMENTS
MENTOR
SIGN
& DATE
17
13. COMMUNICATION
“Demonstrates ability under supervision to care for patients post-operatively; applying knowledge & skill to deliver safe care.”
KEY SKILL
COMPETENCY
Communication in critical
care
Discusses with mentor the importance & impact of communication in
terms of:
 Patient communication – explaining procedures/consent/day/night
orientation etc
 Relative/next of kin communication – amount of information/patient
confidentiality etc
 Reporting on any condition changes to nurse in charge / medical &
anaesthetic staff / MDT etc
 Consistent/concise/clear/legible documentation
 Data protection policies/confidentiality policies/NMC code of conduct
© Critical Care Student Nurse Handbook ABUHB: Year 2 AK/DAH/SJM, updated 2015
EVIDENCE OF LEARNING &
COMMENTS
MENTOR
SIGN
& DATE
18