Intensive Care Unit/Progressive Care Unit
Intensive Care Unit (ICU)
As an ICU nurse at any of Community’s three hospitals – North, East and South – you will join a dedicated team of RNs who provide care based on promises made to our patients and their families. These promises include a high quality and safe experience that is compassionate, special, and timely.
Working to treat a number of critical conditions, Community nurses in the ICU respond to patient needs using state-of-the-art equipment and technology. Education and cross-training opportunities enable our nurses to respond quickly to a number of diagnoses and crises.
According to Community East ICU Clinical Director, Sherri Crawford, her team shares a collective approach to every situation.
“We are team oriented…really! It’s not just a term for us. Everyone here is self-motivated, meticulous about details, and committed to providing exceptional care. Qualities like these really help us pull together and stay focused in challenging situations,” she shares.
Collectively speaking, the ICU at all three hospitals collaborates effectively with physicians and shares a solid rapport with all staff. In fact, ICU RNs provide mentoring and support to all areas of the hospital through the ICU consult model.
It’s an ideal environment for nurses who want to be involved in active leadership teams led by professionals who are focused on quality improvement.
Nurses choose to stay in the ICU for a number of reasons – the true teamwork nature in the ICU, close relationships with managers and colleagues, the continuous learning environment, and autonomy.
This kind of closeness supports positive patient experiences in the ICU, which are enhanced by practices such as pet therapy visits, open visiting hours, and overnight accommodations for out-of-town family members.
- North: 24-bed private room unit with hard wire monitor capability in every room
- East: ICU is 12-bed private room unit with hard wire monitor capability; CCU is 12-bed private room unit with hardwiring
- South: 8-bed private room unit (expansion to 12 beds in 2010)
- Adult medical/surgical patient population including- respiratory failure including complete ventilator support, neurological – including stroke, and post op care, cardiac and vascular, drug overdose, renal – including acute and chronic, complicated post op surgeries, multi system organ failure and sepsis
- Admission age is 16 years and older
- ICU has a board-certified intensivist in house 24/7, 365 days a year
- Management on site 24/7
- Multidisciplinary team approach to patient care including physician, respiratory therapy, non-licensed staff (PSP, SNE, and AP), dietary, pharmacy, and case management
- Multidisciplinary communication form used daily to share plan of care
- ICU does not use agency – staff is unit based
- Staffing ratio 2:1 for ICU level of care, 1:1 for high acuity, and 3:1 for PCU level of care
- ACLS-certified ICU charge nurse provides code blue coverage and consult coverage (rapid response team)
- Dedicated ICU Pharm D (clinical pharmacist) on unit Monday thru Friday and weekend availability by pager
- Bedside dialysis provided by Fresenius
- State-of-the-art equipment includes SMART IV pumps, Vigileo monitor, Sonasite (ultrasound device) to assist doctor with difficult line insertions and bronchoscope for difficult intubations
- Diagnostic equipment in unit includes Swan ganz catheters, arterial lines, “Camino” ICP monitor, “PRISMA” for CVVH, Vigileo monitor, continuous cardiac output monitor
- Active involvement in city and national collaboratives to improve patient outcomes, including VHA’s TICU project to decrease ventilator acquired pneumonia and length of stay on ventilators
- Ventilator Acquired Pneumonia (VAP) free since June 2006
- Strong mobility program, including all stable ventilator patients up in chair twice a day
- Mobility hardwired into plan of care for all patients. “Lift team” assists with mobility and increases staff satisfaction
- Daily Sepsis Screening (more frequently if required) and ICU code blue nurse performs sepsis consults for the hospital
Progressive Care Unit (PCU)
Nurses in the PCU at any of Community’s three hospitals – North, East and South – follow strong guiding principles in providing patient care. To exceed expectations, RNs provide an environment of trust and respect that enables physicians and employees to realize their full potential as individuals and members of the health care team.
The nurse to patient ratio in the PCU is three or four to one with PSP, SNE, and unit secretary support.
Typical diagnoses on the unit include but are not limited to respiratory failure, overdose, pneumonia, and end stage renal disease. Caring for patients with such serious conditions requires the active, shared leadership and exceptional physician collaboration that is noticeable in the PCU.
“Our nurses are dedicated to providing exceptional care,” says Community East PCU Clinical Director, Sherri Crawford. “Their ability to keep up with the high activity level on the unit is a testament to the pride they have in their calling.”
PCU nurses at Community say their unit is special for a number of reasons – the most important of which is the staff. Everyone pulls together for the good of everyone else, and there’s always someone there to help whenever a challenge presents itself.
Like the ICU, the PCU also promotes positive patient experiences through pet therapy visits, open visiting hours, and overnight accommodations for out-of-town family members.
Education and cross-training opportunities in the PCU include ACLS, NIHSS certification, PCCN certification, cross-training to the ICU, and precepting opportunities.
- North: 32-bed unit
- East: PCU-12 bed private room unit, CV PCU–11 bed private room unit with hardwiring
- South: 20-bed private room unit (expansion to 24 beds in 2010)
- Complex patient population including renal, cardiac, neurological, bariatric, and multi-system failure
- Highly trained, primarily BSN staff
- RN staffing ratios of 1:4 and 1:3
- ACLS certified RN staff
- Staff with strong planning, critical thinking, and communication skills
- Resource team RN’s trained in PCU (no agency staff)
- Intensivist coverage 24/7
- Open visitation hours for improved patient/family participation
- Integration of goals for safety, high quality, compassionate, special, and timely experiences
- Point-of-care electronic documentation
- Point-of-care glycemic testing
- Continuous infusions (vasoactive, vasopressive, and other infusions) including insulin, heparin, natrecor, dopamine, dobutamine, nitroglycerin, amiodarone, cardizem, sandostatin, and others
- Bedside dialysis provided by Fresenius
- State-of-the-art "smart" IV pumps and PCA devices with capnography
- Collaborative, multi-disciplinary team approach including programs such as Life’s Journey
Management on-site 24/7