Creating Coronary Care Units and Empowering Nurses

The coronary care unit (CCU) concept was proposed in 1961 as a strategy to save the lives of patients hospitalized after an acute myocardial infarction (heart attack). The notion was to place vulnerable patients in an area where their heartbeats were monitored continuously and where specially trained nurses could initiate cardiopulmonary resuscitation (CPR) if a patient had a cardiac arrest. Cardiac defibrillators and temporary pacemakers, technologies developed in the 1950s to treat life-threatening heart rhythms, were combined with CPR in 1960 in an attempt save patients’ lives. Nurses played a vital role in CCUs, and the new care model transformed the traditional nurse-doctor relationship. Nurses were trained to initiate life-saving treatments without a physician being present. The resulting empowerment of nurses had significant implications for their status as health care providers. The CCU movement also contributed to the development of cardiac arrest teams and paramedic-staffed, defibrillator-equipped ambulances.