What to expect in a subintensive care unit

[BINOC]

I am a fourth semester nursing student trying to prepare for a preceptorship in sub-ICU. What can I expect to learn/do in sub icu? Surprisingly a google search did not yield much and it doesnt seem like all hospitals have sub icu's ..or do they but just known as something else?

any help would be greatly appreciated!

[Nurse Kyles, BSN, RN]

Here are some other names for this type of unit: Step-down, Progressive Care, or Intermediate care. (These are the names that are used in my area.) I work on a Cardiac/Progressive Care Unit. This is the criteria for our PCU:

Post PCI with intervention (heart cath with stents)

Cardiac Vasoactive/Antiarrhythmic IV meds

• Amiodarone
  
• Atropine IVP
  
• Angiomax
  
• Diltiazem
  
• Dobutamine
  
• Dopamine
  
• Integrillin
  
• Enalipril IVP
  
• Furosemide
  
• Lidocaine
  
• Metoprolol IVP
  
• Nicardipine
  
• Nitroglycerin
  
• Esmolol
  
• Labetalol
  

Cardiovascular:

• Patients who are at risk for atrial/ventricular arrhythmias or who are being evaluated for possible MI when no Med-tele bed is available
  
• Titrating single infusions on the above listed medications with the exception of the following meds that can run simultaneously (Cardizem and Amioderone), (Lasix with Dobutamine or Dopamine)
  

Respiratory:

• Compromised respiratory function that requires continuous supportive interventions every 2-4 hours
  
• No mechanical ventilated patient may be admitted to the step down unit at this time
  
• Long term tracheostomy patients requiring suctioning no more than Q2H
  
• Respiratory treatments Q2-4H
  
• Bipap patients requiring bipap >8H a day
  

Metabolic

• I /O requiring Q2-4 hour measurement on a continuous basis
  
• Insulin infusions
  

Nursing Care

• Vital signs Q4H or physical assessment more frequently than once a shift
  
• Post op Day #1 Cardiovascular OR patients (open-heart patients)
  
• Post op Day #1 Thoracic surgical patients
  
• Patients requiring transvenous temporary pacing
  

Discharge/Transferring Criteria:

• Patients will be transferred off the PCU when they no longer meet the higher level of care as explained in the criteria.
  

The patient population is usually a mixed bag. I have learned so much, and I bet you will too! Good Luck!

[BINOC]

Thanks! That's very helpful. =)