Report of CNE on “Basics of critical care”

Understanding, identifying and inferring appropriate ECG patterns, ABG values, and trouble shootings of ventilator, Care indicators, Infection control bundles, medication and fluid management in ICU patients become imperative. Chief Guest of the event Dr. (Col) M. Dayananda, the Chief Operating Officer, Kasturba Hospital Manipal highlighted the need for nurses to be well equipped with care aspects as well as to be updated with technological advances. He insisted on having regular training on critical care advances without leaving a single nurse in the hospital and that very responsibility is shouldered on the specialized faculty of Manipal College of Nursing.  

Dr. Anice George, the Dean and Nursing Director and also the guest of honour for the CNE expressed her concern for readiness of the clinical nurses to update their knowledge and skills as accountable nurses working in the critical care areas and be considerate on a patient who is undergoing a difficult moment in the ICU. She feels that a day will come when protocol will include a loved one in the care team.  

Dr. Ranjan Shetty, an eminent Cardiologist of Kasturba Hospital Manipal has driven the ICU nurses to a glimpse of identifying and managing various arrhythmias. He has brainstormed the participants with his mesmerizing ECG patterns and participants taking active part to identify and depict respective management strategies for the problems identified.  

Dr. Lokvendra Singh Budiana, Assistant Professor of Anaesthesia Department, Kasturba Hospital, Manipal spoke on the trouble shootings of ventilator in patient care management and what a nurse needs to be alert about.  

Dr.Rahul Magazine, Unit head department of Pulmonology took the participants to a different level of understanding in regard to identifying acid base imbalances and how a nurse need to activate to correct the imbalances to prevent complications.  

Dr. Sunil Mundkur, Professor of Paediatric department and Quality consultant of Kasturba Hospital Manipal, addressed the nurses on Safety and Quality indicators in ICU. Doing the right thing, the right time for the first time is vital. Each nurse is accountable for patients’ safety as well as for oneself at our workplace. Structure, process and outcome measurement need SMART indicators. Monitoring is a must to bench mark. High care quality happens when process is accurately monitored and right measures are taken care of. Creating awareness among the critical health care team makes them accountable. Good communication, clear understanding of intention towards QI, studying the trends and improvements should be a continuous process.  

Dr. Jyothi Chakrabarty and Ms. Swapnil spoke about the role of nurse towards assessment of patients who are critically ill using FAST HUG BIDS (Feeding, Analgesia, Sedation, Thrombo-Prophylaxis, Head end elevation, ulcer prophylaxis, glycaemic control, Bowel and bladder, Invasive lines, De Escalation or escalation of antibiotics and spontaneous breath trials) approach.  

Dr. Elsa Sanatombi Devi, Mr. Romeo Mathew & Ms. Glory Waghela discussed on the Hospital Acquired infections and ICU bundles. Breaking the chain of infection becomes vital. Health care professionals are responsible for patients’ and self-safety. Bundles of practices make health care professionals’ practice safe. All or none policy is the rule and nurses play a major role to health care policy change.  

Hands on work station on ECG interpretations, ABG analysis, Injection, Infusion safety devices, and catheter care were demonstrated by Mrs. Melita Sheilini, Mrs. Shalini Nayak, Mrs. Leena Sequira, Mrs. Tandra Kabiraj, Ms. Mareena Mathew, Ms. Swapnil Thulung, Mrs. Noreen Veera, Ms. Katha Mukherjee, and Ms. Rynel Desma Quadras respectively.  

Watching participants demonstrate each strip of scenario and live device demo made us feel re-energized. Having to have an opportunity to interact and train the nurses in critical care basics gives us a sense of accountability and fellow feeling towards our fellow nursing counterparts.  

During the valedictory function, Dr. Judith A Noronha expressed her views on quality patient care and how a vigilant nurse can save a patient in an emergency situation. She also added that evidence based care is the only solution to quality care. Nurses need to keep one-self up-to-date. Moving ahead towards quality care begins with a nurse following quality indicators and updating one’s higher education yet keeping empathetic approach abreast with every dealings in patient care as patient’s expectation keeps increasing. Nursing care becomes challenging in an emergency situation with an acute patient who is seriously ill and time-dependent issues as well as stress mounted on the nurse. This calls for high level training, keeping oneself up-to-date, providing evidence based care and monitoring quality indicators.