Critical Care Nursing Outside of the Hospital

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Specializes in ICU.

Hello All!

I have been thinking about this for a long time and was just wondering if there exists for critical care positions outside of the hospital. I'm a very creative person, and I was thinking of creating such an environment later down the line in my career, to bypass the hospital chaos. Anybody know of such companies that work in an environment like this? Would love to speak with a representative of one in Houston

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Specializes in critical care, ER,ICU, CVSURG, CCU.

interesting, i can see some home care, in a critical care format ;)

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I can see the need for 'critical care' in a very underserved area, in a developing country for instance. It's hard to imagine making this happen in the US, for instance. But creativity is what the future of nursing needs. Best to you and your creative ideas! I'd love to hear more.

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Specializes in ICU.
interesting, i can see some home care, in a critical care format ;)

I was thinking just the same @sallyrnrrt! The cost of having someone a resident in a hospital is extremely expensive. If we could bring the services to the house, or nursing home, having a nurse with vented patients at home with shift work, with an oncall Dr not too far from the pt, would be an excellent idea. I have a couple other ideas with this, but am going to keep them to myself for now. Sky is the limit with no ceiling!!

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Specializes in Complex pedi to LTC/SA & now a manager.
I was thinking just the same @sallyrnrrt! The cost of having someone a resident in a hospital is extremely expensive. If we could bring the services to the house, or nursing home, having a nurse with vented patients at home with shift work, with an oncall Dr not too far from the pt, would be an excellent idea. I have a couple other ideas with this, but am going to keep them to myself for now. Sky is the limit with no ceiling!!

This already happens. There are long term acute care hospitals (LTACH), vent units in adult and pediatric nursing homes/LTC, and many complex children requiring trach/vent, TPN, complex central line infusions or even chemotherapy at home. I work as a high tech pediatric nurse in the home caring for trach-vent and medically complex children at home and accompany them to school. Once the children age out there is an adult nursing team that continues their care at home and in the community. I work two agencies and am trach-vent qualified for infants and pediatrics for both. They are adding infusion services on one agency because a clinical manager is highly qualified and was asked to be on the home infusion monitoring team (LPN's can monitor but cannot initiate certain drugs and therapies. The clinical manager would initiate and we (field nurses) would monitor and maintain the central line or PICC infusion ) however both LPNs and RNs are capable of out of hospital trach/vent/CPAP/BiPAP care, monitoring & troubleshooting. A clinical manager and the patient's attending (or designee) are just a phone call away v

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Specializes in ICU.

Oh wow. You don't learn this information in school. Thanks to this nursing platform created for us. LTACH.. Okay.. Thank you for your post @JustBeachyNurse. I'm trying to make my nursing career interesting and fun, having something on the side to do while having a hospital job. I want to be as skilled as I can in this profession.

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Specializes in SICU, trauma, neuro.

What about electronic ICU (eICU)--remote ICU monitoring?

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Specializes in ICU.
What about electronic ICU (eICU)--remote ICU monitoring?

That was one of my retained thoughts! That would be with the oncall MD and PA. Just have to make things happen now. With the way technology is making a mark in healthcare, I'm sure this would be a possibility. Sky is the limit with no ceiling!

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Specializes in Complex pedi to LTC/SA & now a manager.
That was one of my retained thoughts! That would be with the oncall MD and PA. Just have to make things happen now. With the way technology is making a mark in healthcare, I'm sure this would be a possibility. Sky is the limit with no ceiling!

Again this already exists--remote icu/eICU monitoring. Some facilities use remote telemetry monitoring for all telemetry (non ICU/CCU) units to save staffing monitor techs

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Specializes in ICU.
however both LPNs and RNs are capable of out of hospital trach/vent/CPAP/BiPAP care, monitoring & troubleshooting.

I guess that what you meant here with the eICU monitoring. If they can completely monitor drip readings (some pumps have remote monitoring in the hospitals), vent settings and progress, and the already known tele, via eICU monitoring at a remote location (MD or NP remote oncall location), I have to get in on this. This is so wonderful. I'm about keeping the health costs within reason for the patient. To me, a $5000+ night stay in the hospital is just ridiculous.

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Specializes in CVICU.

Telehealth does already exist (e monitoring), but some states are having a tough time getting laws passed to financially fund it. I am sure the big corporate health systems are funding the fight.

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Specializes in Complex pedi to LTC/SA & now a manager.
I guess that what you meant here with the eICU monitoring. If they can completely monitor drip readings (some pumps have remote monitoring in the hospitals), vent settings and progress, and the already known tele, via eICU monitoring at a remote location (MD or NP remote oncall location), I have to get in on this. This is so wonderful. I'm about keeping the health costs within reason for the patient. To me, a $5000+ night stay in the hospital is just ridiculous.

The eICU doesn't reduce hospital stay or cost. It just eliminates 6-8 staff members and reduces employee cost burden. Even if monitor techs are paid minimum wage it affects the facility cost burden. It doesn't always require a nurse to monitor telemetry. So this is not necessarily creating home or distance based critical care nursing jobs.

LTAC/LTACH often are quite often lower cost than acute hospital critical care and opportunities for critical care nurses.

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