Critical Care Association President Wants Nurses to be Heard

A self-proclaimed millennial, Amanda Bettencourt, PhD, APRN, CCRN-K, ACCNS-P, is serving a one-year term as president of the world’s largest specialty nursing organization, the American Association of Critical-Care Nurses (AACN).

Amanda Bettencourt, APRN

We spoke with Bettencourt about her concerns for critical care nursing, what she loves about being a critical care nurse, how the pandemic changed the nursing specialty, and more.

Q: What are the most pressing issues for critical care nurses?

A: The first would be the staffing crisis. A 2021 work environments survey done by AACN found that only 24% of the responding nurses said they have appropriate staffing levels more than 75% of the time.

There is a floor below which safe nursing care can’t be delivered, and that’s true in the ICU just like it’s true everywhere else.

Another concern, which is not limited to critical care nursing, is a lack of nurses’ voices in crucial decision making. We need to make sure that nurses are at the table and their input is valued when important decisions are made in hospital settings, whether it’s about patient care or policies and procedures that affect the way that we work.

Broadly speaking, both issues can be addressed by implementing the AACN Healthy Work Environment Standards. There is so much evidence that when work environments are healthy, nurses are more satisfied, they provide better care, and patient outcomes are better.

Another big issue that we’re dealing with, especially in critical care, is how we support new graduate nurses who are entering such a volatile healthcare environment. They’re facing shorter orientations with fewer educators and clinical nurse specialists. There are fewer layers of the support that used to be present in the hospitals to help their transition to practice.

Q: How do experienced and new nurses become ICU nurses?

A: I was fortunate as a new grad to go directly into the pediatric ICU. When I graduated from nursing school about 15 years ago, it was more common to work on the medical-surgical unit first to get a few years of experience before moving into critical care.

What the pandemic has shown us is that there are many paths to becoming a critical care nurse. Today, there are lots of opportunities, such as in a residency program — which a lot of hospitals have — or finding a supportive environment where you like the nurse manager and feel your growth is going to be supported to “try out” the ICU and see if you like it.

In critical care, there are so many critical care specialties — neuro ICU, trauma ICU, cardiac ICU, pediatrics, neonatal, and medical ICUs. In a residency program, you can usually experience all the different types of critical care and choose the one that fits best. Finding that place where you feel like you fit is so important. You want to enjoy the patient population and know that you’re making a good contribution, but you also want to feel like you have a good team supporting you.

Q: Did the pandemic …read more

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