The development of critical care in England.

The paper offers a view of the development of critical care from the position of nursing. The nursing contribution is not fully acknowledged in the historical and professional literature. This paper offers an alternative history of the development of intensive care (ICU), which takes account of the nursing profession's contribution, rather than the commonly held view that ICU developed predominately as a result of new and innovative technology. The technology was not new but rather it was transferred, usually from the operating theatre, and applied to new conditions. There were many contributing factors that shaped the development of intensive care. One was the grouping together of sick patients so that they could be cared for by skilled nurses who 'watched over' them, by providing detailed observation. This paper outlines the development of intensive care in England from 1952 to the new millennium. It begins with an analysis of the changing definitions reflected in policy and professional documents before moving on to examine the factors that influenced its development and concludes with a discussion of the nursing contribution and future direction.