Education and staffing in the ICU: past, present and future

'Back to the bedside': graduate level education in critical care

The need for post registration education for nurses practising at specialty level in critical care environments is widely acknowledged in nursing and educational literature. There is also clear consensus that the ultimate aim of educational preparation and practice development is to improve the delivery of nursing care to patients who are critically ill and provide support for their families. Yet the 'right' approach to educational delivery and evaluation is less clear and stimulates considerable debate amongst nursing educators, care providers, learners and regulatory bodies. The need for critical care nurses to apply advanced knowledge and technical skills to complex and dynamic practice situations necessitates the development of critical thinking and a problem-solving approach to clinical practice that can be fostered through education and experience. This paper explores the relationships within teaching, learning and practice development in critical care nursing and questions the popular assumption that 'post graduate (Master's level) education fits all'. Discussion focuses on the successful development and implementation of graduate level education for critical care nurses in the South Island of New Zealand and how this development is challenging existing approaches to the provision and evaluation of formal critical care education in New Zealand.

An analysis of professional, specialist and advanced nursing practice in critical care

A recent document, The Future of Professional Practice--Standards for Education and Practice Following Registration (United Kingdom Central Council (UKCC) 1994a), has laid down a structure for clinical practice, providing a pathway for nurses to progress from the professional level, through to specialist and advanced levels, according to clinical expertise and educational preparation. The purpose of this article thus sets out to analyse critically these distinct levels in relation to critical care nursing. In particular, the paper discusses the development of advanced practice and how the proposed levels may be integrated within critical care.