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Discussion

Intermediate care units?

What exactly is an intermediate care unit? Is it like critical care? Somebody said it was a step down from that but didn't exactly explain to me what it entails of and what kind of patients I would see. I'm graduating next month with my BSN and dont want to work in critical care because I dont want to be a critical care nurse but would this be okay for me to work in? I see there is a day position available and I have an interview for a night med/surg position but I would rather have days because it would work best with my family so I was going to ask about this position as well during my interview. I hope that doesnt come off looking bad. Any tips or advice would be much appreciated

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    In California a step-down unit is defined in hospital licensing regulations. At minimum you should insist on education and experience including advanced cardiac life support (ACLS) as part of orientation.

    The licensed nurse-to-patient ratio in a step-down unit shall be 1:4 or fewer at all times. Commencing January 1, 2008, the licensed nurse-to-patient ratio in a step-down unit shall be 1:3 or fewer at all times.

    A "step down unit" is defined as a unit which is organized, operated, and maintained to provide for the monitoring and care of patients with moderate or potentially severe physiologic instability requiring technical support but not necessarily artificial life support. Step-down patients are those patients who require less care than intensive care, but more than that which is available from medical/surgical care.

    "Artificial life support" is defined as a system that uses medical technology to aid, support, or replace a vital function of the body that has been seriously damaged.

    "Technical support" is defined as specialized equipment and/or personnel providing for invasive monitoring, telemetry, or mechanical ventilation, for the immediate amelioration or remediation of severe pathology.

    http://www.cdph.ca.gov/services/DPOPP/regs/Documents/R-37-01_Regulation_Text.pdf

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    The Intermediate care job description depends on the unit.

    I have worked in areas with various duties.

    Many, many days I was a critical care nurse... because the patient would quickly change from stable.. to unstable.

    We are responsible to be vigilant.. switch rapidly.. and handle the other patients in the meantime.

    This does not seem like a good fit for you.

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    At my hospital, step down units usually take patients who have spent time in the ICU, and are mostly better, but still need a bit closer attention/management then general care floor. Usually, staffing ratios are better then the floor (I think 3:1 in IMC, with 2:1 in ICU) Our IMC takes stable, trached, vented patients, a few vasoactive drips (Mostly nitro I think).

    We help train our IMC nurses by having them spend some time in the ICU so they know what they will be dealing with. A few experiences with sickies, vents and drips, and then try to get them stable patients so they can experience it while still having an ICU nurse as a back-up.

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    for us we take tele pts , insulin drips, dilt drips, people getting metropolol push...ect..... the ratio is 4:1 and based on your description it does not sound like a good fit for you. most of our patients are up walking and talking ....so i wouldn't say its like the icu at all on my particular floor but there are a lot of very sick people we are caring for that requires critical thinking.

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