Some hospital patients who leave the intensive-care unit still need constant monitoring and may be transferred to a step-down unit. There, patients' heart rate and rhythm, blood pressure, blood oxygen, respiration and medical conditions receive close attention.
Regency Hospital in Golden Valley is a long-term, acute-care hospital that has a step-down unit as well. "We see a whole range of patients, from those who require extended ventilator and ICU care to those who have had difficulty with healing wounds and have complex medication regimens and comorbidities," explains Rebecca Wong, Regency's director of clinical services.
Nurses need specialized training
Nurses must take electrocardiogram training at the hospital, and 64 hours of an online training program by the American Association of Critical Care Nurses, plus additional didactic training, Wong says.
Other step-down staff includes respiratory therapists, monitor technicians, certified nursing assistants, physical, occupational and speech therapists, wound-care nurses, dieticians, case managers, social workers and pharmacists, according to Wong.
Hennepin County Medical Center has a 12-bed step-down unit within its 48-bed surgery/trauma/neurology unit (STNU). The STNU has 75 registered nurses and 30 healthcare assistants, also known as nursing assistants.
STNU patients may have been in motor vehicle or motorcycle accidents, falls, or have suffered strokes, seizures or spinal cord injuries, according to Sandie Cochran, clinical educator for the STNU.
To work in the unit, nurses must take electrocardiogram training at Hennepin or another area hospital, plus extra training in medication administration. They also must have advanced cardiac life support training, which is offered at Hennepin.