Demystifying critical care management. Part 1

Many nurse executives avoid an active management role in their hospital's critical care areas, a stance that can result in decreased personal, professional, and institutional efficiency and effectiveness. This article is a guide for applying the management process in critical care units and for helping nurse executives gain control of one of the largest consumers of hospital and nursing resources. This is part 1 of a two-part article.

Perceived job stress, job satisfaction, and psychological symptoms in critical care nursing

This study tested the relationships among perceived job stress, job satisfaction, and psychological symptoms of critical care nurses. A self-administered questionnaire was sent to a sample of 180 critical care nurses from eight hospitals. The results supported the hypotheses that higher levels of perceived job stress are related to lower levels of job satisfaction (r = -.24, p = .001) and to higher levels of psychological symptoms (r = .33, p = .000). These effects remained even when years of experience in nursing and shift were controlled. Item analysis, however, showed that four of the five top-ranking stressors were not related to the outcome measures. A distinction between positive and negative stressors is proposed to explain the pattern of results.

Therapeutic Intervention Scoring System: update 1983

The Therapeutic Intervention Scoring System (TISS) introduced in 1974 has become a widely accepted method of classifying critically ill patients. In response to requests to update the system because of recent innovations in critical care, some items have been deleted, some have been added, and certain point scores have been adjusted. Explanations of items within the system and guidelines for the user are included. A comparison of the new 1983 system to the old 1974 system in 100 consecutive patients reveals no difference in total point scores. We hope this updated explanation will ease the task of assessing use of intensive care services.