The challenge of expanding ICU beds during the COVID 19 pandemic: An overview of the intensive care nursing service




Nursing; COVID-19; Management; Intensive Care.


Objective: Report the organization of the work fronts with the management of the Nursing and Medicine Service of the Intensive Care Center (ICU) for the organization, planning and opening of new critical beds. Method: This is an experience report of ICU nurses, from March to August 2020. To propose a critical reflection of the work process, it will be based on the actions of advanced nursing practice (APS). Results: In the research: multidisciplinary groups were created to review and develop flows and protocols based on evidence-based practice and readaptations to routines. Nurses integrated each group according to their expertise. In education: training was carried out in loco on the adopted care practices. The most emerging themes were attire/dedressing, prone maneuver, hemodialysis and extracorporeal membrane oxygenation (ECMO). Due to the immediate hiring of professionals, face-to-face and distance learning training was prepared. Also, realistic simulations took place. As for care practice: new protocols and care flows were developed. As for management: the units were allocated in the annex to the main building, with clusters of up to 10 beds being opened, totaling 105 beds. The team was resized, groups were restructured, allocating experienced nurses and nursing technicians in new units for training admissions and patient safety. Daily Huddles were carried out to map occupational and care risks. Conclusion: Through the critical-reflective process and planning, new strategies were essential. In order to redesign our purpose, there was a need for constant adaptations, as the pandemic scenario remains unpredictable.


Almeida, L. (2020). Educação e Saúde: Relato de Experiência em um Processo de Formação em Gestão e Educação em Saúde.Eixo 16- Educação e Saúde. XIV, 1982-3657.

Associação de Medicina Intensiva Brasileira-AMIB. (2020). Recomendações para o bem-estar emocional da equipe multidisciplinar durante a pandemia pelo Sars-Cov-2: pelo Departamento de Psicologia da AMIB.

Brunette V., & Thibodeau-jarry N. (2017). Simulation as a tool to ensure competency and quality of care in the cardiac critical care unit. Canadian Journal of Cardiology. 33(1):119-27.

Bryant-Lukosius, D., & Martin-Misener, R. (2016). ICN Policy Brief. Advanced Practice Nursing: an essential component of country level human resources for health. ICN. pillars/sew/HRH/ICN_Policy_Brief_6.pdf

Cavalcante, A. C. (2015). Cuidado seguro ao paciente: contribuições da enfermagem. Rev Cub de Enfer. 31(4):0-0.

Disease Control and Prevention - CDC. (2020). COVID-19 Response Team. Severe outcomes among patients with coronavirus disease 2019 (COVID-19). MMWR Morb Mortal Wkly Rep; 69:343-6.

Kurtzman, E. T., & Barnow, B. S. (2017). A comparison of nurse practitioners, physician assistants, and primary care physicians’ patterns of practice and quality of care in health centers. Med Care. 55(6):615–22. https://

Jason P., et al. (2020). Intensive care management of coronavirus disease 2019 (COVID-19): challenges and recommendations. The Lancet. Respiratory Medicine. 1-12.

Neto, M. V. M., et. al. (2018). Prática avançada em enfermagem: uma possibilidade para a Atenção Primária em Saúde? Rev Bras Enferm [Internet];71(supl1):764-9.

Organização das Nações Unidas. ONU. (2015). Assembleia Geral das Nações Unidas. Transforming our world: the 2030 agenda for sustainable development. DRAFT for consultation. ONU. hrh/resources/glob-strat-hrh_workforce2030.pdf?ua=1

Vedovato, et al. (2021). Trabalhadores(as) da saúde e a COVID-19: condições de trabalho à deriva? Revista Brasileira de Saúde Ocupacional.

Zhang Y., et. al. (2020). The novel coronavirus outbreak: what we know and what we don't. Cell. 180(6):1034-6. 2-8674(20)30171-9.pdf

World Health Organization. (2020). Oxygen sources and distribution for COVID-19 treatment centres: interim guidance, World Health Organization.



How to Cite

CANDATEN , A. E. .; MORETTI, M. M. S. .; SCHMITZ, T. dos S. D. .; TAVARES , J. P. .; AZZOLIN , K. de O. .; BORBA, D. dos S. M. .; HAAS, J. S. .; BARCELLOS, R. de A. .; HOCHEGGER, T.; OSTERKAMP, L. The challenge of expanding ICU beds during the COVID 19 pandemic: An overview of the intensive care nursing service. Research, Society and Development, [S. l.], v. 10, n. 9, p. e18810917908, 2021. DOI: 10.33448/rsd-v10i9.17908. Disponível em: Acesso em: 21 sep. 2021.



Health Sciences