The practice of nursing requires specialized knowledge, judgment, and skills to provide care to groups and individuals. The RN utilizes knowledge derived from the principles of biological, physical, behavioral, social, and nursing sciences to assess, plan, implement, and evaluate patient care.  All care is provided based on the concepts inherent in the model of care for TCH which promotes an on-going partnership between patients and families and the team of healthcare providers. The care is culturally based and age specific.  The RN adheres to American Nursing Association (ANA) code of ethics and to the scope of practice described in the Ohio Nurse Practice Act.

The Stepdown Clinical Interns are primarily night shift team members. 

The Stepdown Clinical Intern units include:

Comprehensive Medical Stepdown (Comp Med): 3 South is a 29-bed medical stepdown unit specializing in the care of stroke and geriatric patients. The unit offers care to all types of patients requiring cardiac monitoring including cardiology, renal, endocrinology, general medicine, pulmonology, gastroenterology, and oncology. Family Practice Providers are our main source of patients. 3 South Patient Care Assistants are EKG trained and have a Point of Care certification. Health Unit Coordinators (HUC) on 3 South manage the patient flow, patient requests, and physician consults along with many other duties. They also complete training as a Cardiac Monitor Reader (CMR) and share time in both roles as a HUC and CMR. Registered Nurses on 3 South are NIH Stroke certified in the first 6 months. Our nurses have opportunity to become charge nurses and preceptors. All 3 South team members participate in annual education days and are supported by a Professional Development Specialist, in addition to the Clinical Manager and two Assistant Clinical Managers. 

Cardio-Pulmonary Stepdown: The Cardio-Pulmonary Stepdown/4 South unit is a 20-bed medical stepdown unit specializing in the care of patients diagnosed with acute MI, cardiac arrhythmias, cardiomyopathy, CHF and other low risk cardiac/chest pain diagnoses. Cardiopulmonary Stepdown also cares for patients who are long-term ventilator dependent. We offer general medical services to all types of patients requiring cardiac monitoring including cardiology, renal, endocrinology, general medicine, pulmonology, gastroenterology, and oncology. Staff on this unit undergo special training and education regarding non-invasive positive pressure ventilation (Bi-PAP, C-PAP, and A-PAP). They also provide infusion therapy, transfusions, injections, and central line care. Patient care assistants on this unit provide support with ADLs, POC glucose testing, and 12 Lead EKGs.  4 South is a dedicated stroke unit and all RNs are NIH stroke scale certified. 

Telemetry Stepdown (Cardiology): The Cardiac Medical Stepdown/6 South unit is a 28-bed unit specializing in the recovery of patients following vascular and electrophysiology procedures.  In addition, they specialize in providing care to patients with acute MI, cardiac arrhythmias, syncope, cardiomyopathy, and heart failure.  They offer medical services to all patient populations requiring cardiac monitoring.  Other services provided within this unit include titration of multiple intravenous medications and conscious sedation for cardioversions.  All nurses are ACLS certified and have successfully completed an ECG interpretation course.  This is an excellent unit for nurses interested in transitioning to an ICU setting.  

Heart & Vascular Medical Stepdown (Heart Failure): The Heart Failure/7 South consists of 28 private medical stepdown beds in a family-centered environment. In addition to caring for heart failure patients, the unit specializes in the care of patients diagnosed with MI, cardiac arrhythmias, syncope and cardiomyopathy as well as the recovery of patients following ablation, pacer placement/ICD and PTA. Medical services are offered to all types of patient populations requiring cardiac monitoring, including renal, endocrine, pulmonary, oncologic, general medicine and geriatric. Other services provided within this unit include titration of multiple intravenous medications and conscious sedation for cardioversions. In addition, a select group of nurses complete special training to provide ultrafiltration for decompensated heart failure patients and left ventricular assist device (LVAD). All nurses are ACLS certified and have completed an EKG interpretation course. This is an excellent unit for nurses interested in transitioning to an ICU setting.

Cardiovascular Stepdown (CVSU): The Cardiovascular Step-Down Unit is a 32-bed, surgical step-down/progressive care unit. The primary focus of this unit is cardiothoracic surgery and interventional cardiology. Patient populations include LVAD, innovative valve replacement, pectus excavatum and post STEMI. Nursing care includes management of cardiac arrhythmias, titration of multiple intravenous medications and conscious sedation for cardioversions.  All nurses on this unit are ACLS certified, have successfully completed an ECG interpretation course and follow the AACN Progressive Care Guidelines. Nursing staff possess and maintain specialty skills including chest tube removals, femoral arterial line removals, complex external pacing, ACT and iSTAT point of care testing and much more.  CVSU staff includes a clinical manager, clinical assistant managers, clinical educator, registered nurses, patient care assistants, health unit coordinators, cardiac monitor readers and exercise physiologists. Specialty certification and minimum BSN education for staff on this unit are highly encouraged.