Nursing and Midwifery Office

ENROLLED NURSE - CRITICAL CARE UNITS

Purpose

The Enrolled Nurse - Critical Care Units project aims to evaluate the potential for a role for Enrolled Nurses (ENs) in Intensive Care Units (ICU) in NSW.

Update - March 2008

Working party members have been engaging with staff in Intensive Care Units that have expressed an interest in undertaking pilot programs to plan the six-month pilot programs. The latest update in relation to the progress of the pilot programs can be found in the March 2008 information sheet below.

To date, Intensive Care Units at St Vincent's and John Hunter Hospitals have commenced pilot programs. Intensive Care Units at Hornsby and Tamworth Hospitals are expected to circulate expressions of interest for Endorsed Enrolled Nurses to be seconded into pilot programs in the very near future. The Intensive Care Unit at Orange Base Hospital is reviewing its proposal and working through some challenges in relation to the format of their pilot program.

The working party met in November 2007 and meets mid March 2008 to discuss progress of the pilot programs in individual sites or planning for the programs still to commence. Between November 2007 and March 2008 the working party members have been planning locally for the pilot programs within their units.

A meeting of the Reference Group is scheduled for April/May 2008 to update progress of the pilot programs, positive aspects and challenges to date.

Background

Currently there are widespread shortfalls of all hospital nurses including shortages of experienced and specialised nurses in areas such as midwifery, intensive and critical care and mental health. These shortages will be exacerbated by the ageing of the nursing workforce and the number of retirements expected over the next ten years. The Critical Care Nurse Workforce in Australia 2001-2011(AHMAC 2002) identified concerns about the availability of critical care nurses. The ICU nursing workforce is currently registered nurses (RN). ICUs in NSW public hospitals generally allocate a nurse:patient ratio of at least 1:1 for intensive care patients, which is not always the case in some other countries in the developed world. ENs are not presently employed in a patient care role in ICU in NSW. The EN role will enhance the team and its flexibility and is in no way intended to replace the RN role.

Margaret Kelly has been seconded to the Nursing and Midwifery Office, NSW Department of Health (part time) to co-ordinate the project. Margaret worked in ICU for 13 years and is currently the CNC for Nursing Research and Practice Development at The Children's Hospital at Westmead.

Reference Group

A Reference Group with representatives of key stakeholders, including ICU staff, ACCCN, ENPA, The College of Nursing, Consumers and the Nursing and Midwifery Office (NaMO) have been meeting every three months from July 2006 to discuss progress and evaluation of the project.

Six ICUs across NSW Area Health Services expressed an interest in being potential pilot sites and planning the requirements for a pilot program.

Working Party

A Working Party of RNs from the potential ICU pilot sites, ENs and the Intensive Care Co-ordination and Monitoring Unit (ICCMU) are responsible for:-

• Developing a communication strategy and project plan for this project.
• Working with ICU staff to map the process of patient care and identify a potential role for ENs in ICU.
• Drafting a position description for the EN in ICU.
• Developing an education program for RNs and ENs.
• Identifying support needed for RNs and ENs.
• Developing the evaluation framework.

The Working Party is currently represented by:-

• Margaret Kelly - Project Officer (Chair), Nursing and Midwifery Office, NSW Department of Health
• Kyla Smith - Nursing Unit Manager ICU, Hornsby and Ku-ring-gai Hospital
• Diane Kowal - Manager, Intensive Care Co-ordination and Monitoring Unit
• Matthew Salerno - Acting Nurse Educator ICU, John Hunter Hospital
• Vicki Thompson - RN (formerly EN), Orange Base Hospital
• Nicky Glenister - Nursing Unit Manager ICU, St Vincent's Hospital, Sydney
• Samantha Faithfull - Nursing Unit Manager ICU, St Vincent's Hospital, Sydney
• Leanne Stacy - RN, Tamworth Rural Referral Hospital

The Working Party has engaged with staff in the pilot sites at every step of the process in planning pilot programs identifying barriers and strategies to address challenges.

Please see the notes of meetings and information sheets for further details on planning processes and progress of the pilot programs.

Links to minutes of Working Party Meeting can be found below:-

January 2007
February 2007
March 2007
April 2007
May 2007
June 2007
July 2007
August 2007
September 2007
October 2007
November 2007
March 2008

Information Sheets

January 2007
April 2007
August 2007
March 2008

Further Information

For further information contact the Project Officer on (02) 9391 9529 (alternate Mondays and Tuesdays from 3 March 2008) or via email at makel@doh.health.nsw.gov.au or visit the ICCMU website at http://intensivecare.hsnet.nsw.gov.au.

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