Changes to ventilator settings by nurses: pro/con debate?

Abstract

The French nursing diploma allows nurses to monitor mechanical ventilation but changes in ventilator settings are subject to medical prescriptions. A gap exists between initial training and knowledge and skills actually required to work in an intensive care unit (ICU). Available post-diploma training is diverse and non-compulsory and still does not give them the right to change ventilator settings. Developing specific and systematic intensive care training to a guaranteed level and a more standardised intensive care practice may improve involvement of nurses in mechanical ventilation. The nurse’s main role is to provide a close and continual monitoring of the patient. Additional training would allow more comprehensive understanding of the patient’s needs, which is essential to a more personalised, efficient, and optimal ventilation. The current work environment of ICU nurses, including staff shortage and high turnover, makes it difficult to organise a time-consuming compulsory training. Changes of ventilator settings by nurses would only be possible based on strict nursing procedures. Is that kind of procedures what really nurses and ICU teams want?