I work on a Med/Surg Observation unit. The basic concept is that patients who are borderline on whether or not they should be admitted as regular inpatients are admitted to an observation unit for just that-an observation period after which they are either discharged or admitted as an inpatient. I haven't worked on this unit for long, so I am still learning the details, but my experience has been that a lot of people who are supposed to be moved off of our unit after their obs period is up remain on our unit anyway, which is kind of annoying but probably not the case in all hospitals. Also, some of my co-workers have told me that at least some Medicare patients are now required to be admitted as an observation patient first before being admitted as a regular inpatient, which means that we get some patients that really aren't appropriate for an observation unit (although not unsafe, if they have anything acutely critical going on we send them to CCU or ICU). Typical Obs patients would be acute chest pain that was managed in the ER and we are just keeping them and monitoring their symptoms and cardiac enzymes, acute abdominal pain of unknown origin, acute nausea and vomiting, and acute headache. However, we seem to get the gamut. One day last week I came in to find a patient who had broken her neck, was wearing a neck immobilizer, and had over 30 staples in the back of her head. She ended up getting moved to a post-op inpatient unit, but still...it must have been a Medicare thing, because this woman was obviously more than just an obs patient. That's the government for you, though....(rolls eyes)
In general, an obs unit is not quite as intense as a regular Med/Surg floor because the patients usually go home or go to another floor within a day or two. Lots of patient turnover, though, so you will become expert at doing admissions!