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The Miriam Hospital
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Nursing at The Miriam Hospital
Patient Care Areas: Inpatient Nursing
The cardiovascular thoracic surgical intensive care unit supports 10 cardiovascular surgical intensive care patients in the immediate post-operative cardiovascular surgery period. This unit is equipped with central and invasive line monitoring capabilities as well as telemetry monitoring. Typical procedures include ventilator weaning, use and maintenance of arterial catheters, CAVH, CVVH, BiVAD, intra-aortic balloon pumps, and pulmonary artery catheters. Thrombolytic therapy is administered in this unit and SVO 2 monitoring and sophisticated ventilatory support is employed.
The cardiovascular thoracic surgical intermediate care unit supports 12 cardiovascular surgical intensive care patients in the post operative period following CVTS until discharge.
3-North is a 36-bed surgical and orthopedic/GU neurology unit with 12 cardiac telemetry modules. The most frequent diagnoses are knee, hip and shoulder reconstruction, cervical and lumbar laminectomies, large and small bowel procedures and urological surgeries. On site physical therapy and nursing case management collaborate to facilitate patient's readiness for discharge home or transfer to a rehabilitative service.
3-West is a 36-bed medical/surgical unit with 12 cardiac telemetry modules. It is a general medical but not limited to any population. The medical patients on this unit are not limited to any population. The surgical population includes, but is not limited to, minor bowel procedures and appendectomies.
3-East is a 32-bed medical/surgical unit with 12 cardiac telemetry modules. In addition to general medical patients there is concentration of patients with pulmonary diagnosis, such as pneumonia, COPD, heart failure, CVA and GI bleeding. The surgical population includes but is not limited to minor bowel procedures, and appendectomies.
3B is a 13-bed medical surgical unit with 12 cardiac telemetry modules. The medical patients treated on this unit generally include those with pneumonia, heart failure and nutritional and metabolic disorders. The surgical population includes but is not limited to major large and small bowel procedures. The unit has a centrally located conference room with Internet access available to both patients and staff. 3B has one private room, which is used primarily for patients needing contact precautions.
4B is a 25-bed medical hematology-oncology unit with 12 cardiac telemetry modules. Staff on this unit administer chemotherapy, promote symptom management of oncology patients and work closely with the outpatient cancer center to provide optimal patient care across the continuum. A full time oncology clinician is available to patients and staff in a consultative capacity. Two oncology social workers are on site and work closely with staff and patients. Twenty-three private rooms are available to meet neutropenia and end-of-life patient needs. A quiet room and patient lounge, with Internet access, are available to patients and families. Music therapy and pet therapy programs are offered on a weekly basis.
4-East is a 30-bed medical/surgical cardiovascular unit with 24 cardiac telemetry modules. The medical patients on this unit generally include chest pain, R/O myocardial infarction, and congestive heart failure patients from the emergency department, as well as CCU transfers. In addition, 4east cares for diagnostic and interventional cardiac catheterization patients, and vascular surgical patients. 4-East has two negative pressure rooms to accommodate TB patients. All peritoneal dialysis patients are cared for on 4-East.
4-West is a 30-bed medical/surgical cardiac unit capable of monitoring 24 patients on telemetry. The patient population on 4-West also includes chest pain, R/O myocardial infarction, and congestive heart failure patients from the emergency department, as well as CCU transfers, and diagnostic and interventional cardiac catheterization patients.
CCU is a 9-bed coronary care unit that provides intensive coronary care for adult patients from the emergency department, cardiac catheterization lab, other patient care units and transfers from other facilities. The patient population consists MI patients requiring invasive coronary interventions and arrhythmia monitoring. Typical special procedures include ventilator management and weaning, vasoactive medication titration, pacemaker insertion and Continuous renal replacement therapy (CRRT). Arterial, and pulmonary artery catheters are used as well as the intra-aortic balloon pump.
ICU is a 16-bed medical/surgical intensive care unit that provides care for acute life threatening conditions, resuscitation from cardiopulmonary arrest and intensive management which includes long term life support techniques during single or multiple organ system failure, shock, trauma and the like. Arterial and pulmonary artery catheters and sophisticated ventilatory support is used in this setting. CVVH is used as well. Ventilator weaning is frequent. Two on site intensivists work collaboratively with the healthcare team.
IV Therapy services are provided by RNs on the day and evening shifts. Staffing levels are based on budgeted projected procedures, including IV starts and restarts, PICC and midline insertions.