Moving on from 'patient dependency' and 'nursing workload' to managing risk in critical care.

The contribution nurses make to the management of critically ill patients is usually appraised through the use of concepts such as 'patient dependency' or 'nursing workload'. These concepts fail to address the knowledge, skills and experience of nurses and consequently fail to acknowledge the risk presented by critically ill patients. This paper describes the development of a tool that attempts to measure risk and the process of risk management undertaken by nurses who coordinate the shifts and lead the nursing team. The results of this pilot study indicated that the tool was valid, but reliability has not yet been demonstrated. Thus the tool requires further refinement and testing. We chose to publish at this time because we feel the paper offers a new way of examining the contribution of nurses working in critical care.