What is a step-down unit?

[fmiller007]

Just now trying to familiarize myself with all the areas of a hospital and ran across this term.

Meaning?

And when people say "work the floor", what are they referring to?

Thanks

[OhioCCRN, MSN, NP]

http://lmgtfy.com/?q=step+down+unit

[Do-over, ASN, RN]

In my experience, "The Floor" is anyplace other than specialty areas like ER, ICU, OR, OB.

[fmiller007]

Thanks Do-Over.

And apparently a step-down unit is an area of the ICU where patients whom dont need as much care, but more than others areas of the hospital-- typically go.

So why not just call it a special area of the ICU?

All of this hospital nomenclature is absolutely confusing and thoroughly unnecessary.

Matter of fact-- I think that will be my next post.

[Always_Learning, BSN, RN]

It's called a "step-down" because it's not still ICU; it's a slightly lower level of care. So basically, lower acuity than ICU, but higher acuity than a regular med-surg floor.

[Jenni811, RN]

a step down unit refers to like, your patient is still critical but not critical enough to be in an ICU or CCU setting. Like i work in a cardiac step down unit, so my patients usually come from CCU (coronary care unit). It is a med surg floor technically.

For example, my floor will take patients who had an MI, if they are STABLE MI's. If they are a non stable MI or active chest pain, they go to CCU for higher level of care.

you can kinda think of it is as the ICU/CCU stabilizes the patient and gets them off to a step-down unit.

when a nurse says she "works on the floor" she is referring to being on the unit. Nurses who are managers or work in administration are nurses, but they do not "work on the floor." It is being a nurse and having your own patients. I personally would consider ER "working on the floor", but i could see it both ways.

Hope i described that ok :)

[PeachPie]

I work Neuro ICU stepdown, which means that they're not acute enough to need the ICU, but still need staff with specialized neurological training.

[ktliz]

a step down unit refers to like, your patient is still critical but not critical enough to be in an ICU or CCU setting. Like i work in a cardiac step down unit, so my patients usually come from CCU (coronary care unit). It is a med surg floor technically.

For example, my floor will take patients who had an MI, if they are STABLE MI's. If they are a non stable MI or active chest pain, they go to CCU for higher level of care.

you can kinda think of it is as the ICU/CCU stabilizes the patient and gets them off to a step-down unit.

when a nurse says she "works on the floor" she is referring to being on the unit. Nurses who are managers or work in administration are nurses, but they do not "work on the floor." It is being a nurse and having your own patients. I personally would consider ER "working on the floor", but i could see it both ways.

Hope i described that ok :)

In my area, working "the floor" is distinguished from working "the unit." "The floor" usually refers to Med/Surg or a Med/Surg specialty floor (e.g. orthopedic, oncology, step-down/tele) while "the unit" is basically only ICU.

[applewhitern, BSN, RN]

Usually "working the floor" simply means a medical-surgical unit. "Step-down" in my experience, is a unit where the patients are hooked up to a cardio-resp. monitor, just like in ICU or ER, and require closer monitoring than a med-surg floor, but do not require ICU. You usually cannot titrate drips on a step-down, meaning you can give critical care drips, but only at a set rate. I worked on a step-down where we would take ventilated patients if they were stable, like they had a trach, but this is not the norm. We also did not do swans on the step-down. We did tons of bedside bronchs, cardioversions, post-caths, post-pacemaker insertions, that sort of thing. Our step-down was staffed 4:1.