These professionals work in intensive care, emergency medicine and emergency departments, caring for critically ill people. They assess the needs of the sick person and provide different nursing care by managing their resources optimally and applying critical reasoning and judgement.

They work as members of an interdisciplinary team made up of different health professionals, and their contribution is what guarantees continuity of care to the patient. In cases where urgent-emergency intervention is required, they provide the necessary initial care with the support of referral protocols, stabilising the patient's condition before transfer to the destination hospital.

In situations of accidents with multiple victims, and especially in catastrophes, one of the main objectives must be to carry out immediate triage and carry out the first essential manoeuvres to guarantee the viability of serious patient's and maintain the operability of the care chain in order to stabilise and evacuate the affected persons.

These professionals may carry out their tasks in a primary setting (home, outpatient clinic, public transport) or in a secondary setting (transfer of a critically ill patient from a hospital that is unable to provide the most appropriate and complete treatment with the appropriate means to a hospital with the intensive care services or specialities necessary to care for this type of patient). They work as members of teams in different structures and/or components (doctors, medical transport technicians and other health technicians).

• Identify the patient's altered needs (breathing, haemodynamics, level of consciousness, feeding, etc.) and provide appropriate care to meet them. Promote a healthy and safe environment, taking into account the patient's situation.
• Manage and distribute resources (material, time, etc.) and establish working methods for the correct provision of nursing care. Participate in decisions and prioritisation criteria in therapeutic measures and in the elaboration of protocols and procedures.
• Know the pathophysiology of the main pathologies of emergency patients and of people admitted to intensive care units (respiratory, cardiac, neurological, digestive, obstetric, toxicological, etc.) and apply diagnostic techniques and therapeutic measures appropriate to each situation.
• Know and use monitoring and instrumentation systems, as well as the general and specific principles of treatments in the field of critical illnesses.
• Know the use of drugs commonly used in the ICU, emergency room (sedatives, analgesics, vasoactive substances, etc.) and their clinical applications. Administer drugs and provide the care derived from their application.
• Where necessary, apply advanced life support techniques, both ventilatory and circulatory, cardiopulmonary resuscitation and post-resuscitation care.
• Know, understand and anticipate the complications that may occur in the ICU, maintaining adequate conditions for subsequent recovery. Some complications may be the impact of the anaesthetic plan in critical patients, applying post-operative care in surgical patients, and infections that may be acquired in the ICU, assessing appropriately the patients who acquire them. Other complications may also include sores, muscle problems, etc.
• Identify bioethical problems and apply reasoning and critical judgement in their analysis and resolution.
• Support the family, providing information, accompaniment and education appropriate to the situation of the sick person and their environment. In the case of a terminal situation, accompany the process of dying with dignity.
• Carry out research projects in their field of competence.
• Carry out other tasks related to teaching, patient and family education, research and management.

Regulated training and graduates

• Grau: Infermeria

Complementary training

Courses or postgraduate courses in Critical Patient Nursing Care, Pre-hospital Care, Intensive Care Nursing, Emergency Nursing.
Courses in Cardiovascular and Haematological, Respiratory, Renal, Neurological, Digestive and Endocrine Health Problems.
Courses on Infection Problems in critical patients.
Basic and Advanced Life Support courses.
Courses in Polytrauma Patient Care; mobilisation and immobilisation.
Courses on Care of Patients with Medical-Surgical problems.
Courses in Respiratory Patient Care; mechanical ventilation and respiratory monitoring.
Courses in Cardiovascular Patient Care; arrhythmias, cardiovascular monitoring and defibrillation.
Courses in Intervention in Risk Situations (patients in a state of shock, intoxicated and polytraumatic).
Courses in Nursing Care Management of Patients with Burn Injury
Courses in Mental Health and Substance Abuse.
Courses in Research Methodology in Health Sciences.
Training in Bioethics and Deontology.
Training in Paediatrics.
Training in Obstetrics and Gynaecology

Other specific skills

Out-of-hospital nurses require a minimum of experience in intensive care units, resuscitation, emergency (medical or trauma), major burns and/or cardiovascular disease services.
For professionals who want to start in the emergency department, previous experience is not mandatory, but it is recommended. Consideration will be given to the student's curriculum vitae and the satisfactory completion of the traineeship in these units.

Self-control: Level 3

Initiative: Level 3

Customer orientation: Level 2

Team work and cooperation: Level 1

Concern for order and quality: Level 3

Healthcare

Working to maintain and improve health, as well as physical and mental well-being, is the primary interest of people who are involved in the field of healthcare. Some of the activities in this field include making diagnoses, prescribing treatments and monitoring illnesses and injuries. These activities also include the application of therapeutic treatments (traditional or alternative) with a view to facilitating the physical recovery of those being treated. To carry out these activities, one must have in-depth knowledge of the human body and medicine, in its various specialisations.

Social community worker

Individuals related to the social/community field have an interest in working to improve people's social well-being and quality of life, as well as enhance their integration into their social, family and/or work environment. The professional activities that are common in this field include providing special support and aid to people at risk of social exclusion, designing programmes and implementing resources for the social and cultural stimulation of an area, and acting as mediators for conflict resolution in family, social or interpersonal environments. These activities involve constant interaction with people in order to improve their psychological and social well-being.

Palliative care specialist

Mental health nurse

Osteopath

Nurse

Homeopath

• Work hours

  It is usually a full working day; morning, afternoon or night shifts. There are centres where there are rotating shifts in some units or services. It is worth mentioning that it is easier for recent graduates to join the centres during holiday periods, weekends and night shifts.

• Salary

  Remuneration is variable and is ruled by different agreements. We can talk about a range that goes from approximately 19,399 to 32,861 euros gross per year, working morning or afternoon shifts. The average salary is around 25,248 euros gross per year. Night shifts are paid a bonus, which can reach 6,000 euros gross per year. Other applicable bonuses are those for dangerousness, hardship, maintenance (depending on working hours and shifts, as well as the specific job) and career bonuses.
  
  Source: Study "Observatori d'ocupacions i salaris del Mercat de Treball Actual. Barcelona Activa", elaborated by ICSA Grupo. April 2015.
  

• Professional category

  Technician