The organization and administration of intensive patient care.

Definitions Intensive nursing care is as old as organized nursing. In relation to the adult with a severe illness it means the detailed and enlightened care of the whole patient; the appropriate rest and movement, the feeding, care of the skin and hygiene of excreta. Whether the illness is primarily 'mental' or not does not allow neglect of psychological care by the nurse. This is a theme to be expanded later, but it may be stated now that one of the most rewarding results of working in an intensive care unit is to witness and participate in the close discussion, explanation and encouragement of the individual patient. Intensive Therapy is a convenient label to apply to the activities of a therapeutic team. It is likely that After most of the therapy will be executed by the nurse. The nurse is, and will remain, the front-line therapist in acute illness and the most important administrator of drugs, infusions, inspired gases and food. In addition, she must be conversant with physiotherapy and with the mechanical aids-for example, the respirator, artificial kidney or cardiac pacemaker. If we leave aside the minute to minute therapeutic requirements of resuscitation, then the plan for the intensive therapy of any acute illness is usually well defined; for example, acute renal failure (Merrill, 1965) and status asthmaticus (Grant, 1966). There are invariably some common denominators which can be planned in advance; important ones are oxygen therapy, prevention or treatment of infection and metabolic care.