Exploring Environmental Considerations when Nursing Critically ill People


For critically ill people and their families, the critical care environment in the Emergency Department or Intensive Care Unit is often foreign and confronting. Together with the illness or injury which led to admission, treatment, medication, hospital routines may affect homeostatic body function and control. These external stressors have the potential to affect the person physically, psychologically, socially, culturally and spiritually in a way which may ultimately compromise healing and recovery. It is imperative that while caring for people who are critically ill, that nurses consider the impact of the environment on the person’s illness, healing, and recovery. An awareness of how the environment affects a person who is critically ill, allows nurses to initiate and incorporate nursing care to support the person through their illness by addressing environmental stressors while undergoing treatment in the critical care setting.



  • Identify concepts and interventions related to the patient experience in the critical care setting including addressing physical, psychological, social cultural, environmental and spiritual needs (GA 2, 3, 4, 5 & 6 NMBA 2, 5, 9)
  • Analyse key concepts related to the nurse experience in the critical care setting with regard to ethico-legal dilemmas, total patient care and the impact of the technological imperative (GA 1, 3, 4 & 5 NMBA 1, 2, 9, 10)
  • Reflect on nursing care of critically ill patients using learned concepts and skills in initiating and explaining appropriate nursing actions (GA 1, 2, 4 & 5 NMBA 1, 2, 4, 6, 7, 9)
  • Demonstrate nursing knowledge through critical thinking and the use of relevant professional and scholarly resources to describe, explain and apply key nursing concepts in a writing style appropriate to purpose and context (GA 1, 3 & 4 NMBA 7)
  • Demonstrate the application of basic skills in the use of information technologies to access and utilise resources and evidence-based guidelines suitable for patient health care needs (GA 1, 3 & 4 NMBA 3).




For this assignment, choose ONE of the following, and consider how the environmental factors related to the either the Emergency Department or Intensive Care Unit contribute to a critically ill person’s:

  • vulnerability and alterations in autonomy
  • alterations in communication capabilities
  • alterations in privacy
  • alterations in sleep patterns
  • psychological disturbance and delirium

Explore how the environmental factors related to the Emergency Department OR the Intensive Care Unit contribute to your chosen topic and discuss how nurses can provide holistic person-centred care to minimise the impact of the environment and put the patient in the best possible condition for self-healing. In doing so, consider the environmental impact on the patient’s physical, psychological, social, cultural and spiritual components of self.

The assessment is to be written in essay format (third person) using scholarly academic writing skills. Discussion is expected to be well structured, reflective, analytical and well supported with current literature cited in text and in the reference list using Harvard Referencing style.


No subheading. Begin with an introduction, an overview of the work telling the reader what it is they are about to read. This may be done following completion of the body so that all points mentioned in the introduction are present and in sequence with the body and align with the assessment task.



Be sure your work is well structured and set out in themes. Use specific subheadings that signpost discussion for the reader. Proof read prior to submission to ensure good flow of discussion throughout.




No subheading. You may like to indicate to the reader by commencing with ‘In conclusion,’, To conclude…’etc, then write a concluding statement where you highlight what you have learned from completion of this work (do not simply describe what was discussed).


  • As a rule of thumb in academic writing you should have 1 reference per 150 words – so for a 1800 word assignment this should be at least 12 sources
  • Spelling – this should be Australian spelling – so make sure your spellcheck is set for this and not US spelling

Where can you find this evidence?

  • Use Australian Literature. The emphasis should be on the Australian experience.
  • Library databases – e.g. CINAHL – use your key words to find relevant articles
  • Google Scholar
  • Professional nursing bodies e.g. NSWNMA, Emergency Nurses’ Association, NMBA
  • Government websites e.g. Australian Commission on Safety & Quality in healthcare (particularly relevant if you are looking at medication safety)
  • Health Department websites e.g. good for finding policies, protocols
  • Make sure you are looking current evidence – so from the last 5-10 years
  • NB: don’t just do a google search – you will not find the best evidence this way
  • Don’t use Wikipedia – this is not an academic source – the reason being that anyone can go in and amend or add information at any time so you can’t rely on the validity/truth of this source
  • Don’t forget to use in-text references to back up your discussion
  • If you don’t include a reference – your discussion will read as your opinion and this does not hold weight in an academic piece of writing

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