• General Medical. This area has the largest number of admissions for both acute and chronic illnesses. Patients include those with acute and chronic heart and lung disease and multi-system involvement.
• Ortho/Neuro/Uro Care. Nurses in this area work with multiple types of fractures and joint replacement patients, as well as with trauma and sports medicine injuries. Neuro patients include cervical and lumbar laminectomies, CVA/TIAs post-ICU craniotomy and head injury patients. Urology patients admitted to this unit have a urological or renal problem that may or may not require surgery. TURs, nephrectomies and radical prostatectomies are some of the urological surgeries seen in this area.
• Family Practice. This is mostly a medical unit, so diagnoses can be quite varied and involve a variety of treatments and procedures. Nurses here work closely with the family practice faculty and residents throughout their three-year residency.
• Cardiac Cath Lab. This fast-paced department utilizes the latest technology in performing interventional cardiovascular and electrophysiology procedures. Registered nurses who possess excellent critical thinking skills collaborate with the physicians and other health care professionals to deliver top quality patient care in an ever-changing speciality field.
• Medical Maximum Care Unit. This is a 20-bed maximum care unit with a primary population consisting of those with renal failure and respiratory conditions including ventilator patients and those with a wide variety of medical diagnoses. This fast-paced unit cares for the more acute patient with multi-system failure as well as the chronically ill patient.
• Surgical Maximum Care Unit. This is a step-down unit from critical care offering maximum care for all general surgery patients.
• Oncology. This unit cares for a broad range of patients with a cancer diagnosis as well as those patients with blood disorders. The nursing staff works closely with the physicians to deliver quality patient care, which includes pain control, blood transfusion, IV therapy, chemotherapy, brachytherapy and radiation treatment.
• Patient Resource Team (PRT) Specialists. Patient Resource Team (PRT) Specialists are involved in several aspects of a patient's hospitalization. The team does daily chart reviews and assigns the initial DRG Code. They do insurance certification for inpatients and outpatients as required. They are responsible for coordinating discharge planning and monitoring utilization of hospital days. The job requires a good clinical background and communication skills. Computer skills are helpful. The PRT Specialist plays a major role in the interdisciplinary care team. We have a team of external specialists who follow high-risk patients across the continuum.

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Critical Care
Critical care nursing at Union Hospital is a dynamic team effort. Nurses work in collaboration with the medical staff and other professionals to assure coordinated patient care, from crisis intervention to routine management.

The department has its own educator and an excellent critical care education program. The nursing staff is supported with advanced technology, including computerized monitoring, data collection and charting. In caring for critically ill patients, you make decisions based not only on technical data, but also on your individual experience and knowledge.

Critical care nurses have a choice of specialized units:

• Cardiac Care Unit. Nurses are involved in ongoing patient monitoring and assessment. Patient care is enhanced through the use of the latest equipment, such as the intraortic balloon pump, Swan Ganz monitoring, arterial lines and arrhythmia computer monitoring. Patients are admitted with multiple-system illnesses including acute respiratory, neurological, renal, cardiovascular and gastrointestinal disorders. Multiple trauma patients are cared for here as well.
• Progressive Care Unit. This unit places strong emphasis on patient/family teaching. Nurses work closely with patients to help them begin a rehabilitation program following a myocardial infarction or cardiac surgery. This unit is involved in ongoing patient monitoring by telemetry. It receives patients from all areas who need monitoring but not intensive care. This unit, as well as 1B Telemetry, receives outpatients for CP, placing of permanent pacemakers, AICDs and cardioversions.
• 1B Telemetry. This is a fast-paced 22-bed Telemetry Unit that focuses on the interventional cardiology patient. ACLS certification is required, but can be obtained once you are here.

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Surgical Services
Advanced equipment and techniques keep operating room and postanesthesia recovery room nursing in the forefront of progressive nursing practice. Nurses here are key members of the surgical team, building technical expertise that allows them to handle unexpected situations efficiently. Special areas in this department are:

• Cardiac Surgery. The specially trained cardiac staff members use state-of-the-art equipment in this high-tech facility. More than 275 coronary bypass surgical procedures are preformed annually. Mitral valve procedures are also performed by the cardiac team.
• General Surgery. This is a fast-paced environment where you will work with a range of patients: thoracic, vascular, orthopedic, ob/gyn, ENT, general trauma, neurologic and urologic. Many minimally invasive procedures are performed in urology, orthopedics, gynecology, thoracic and general surgical specialties.
• Endoscopy. Thanks to improved technology, endoscopy is in great demand. Union Hospital's full-service suite provides all the endoscopic procedures including 24-hour pH and manometry.
• Perianesthesia Care Unit. Nurses are involved in the pre- and post-operative care of surgical patients. The nurses work with both outpatients and inpatients. They provide pre- and post-operative planning and care for each patient. Nurses teach both patient and family members to participate in the patient's recovery. Nurses also must have critical monitoring skills as they care for the patient in the immediate postanesthetic period. Perianesthesia nurses provide primary care nursing in the pre- and post-operative setting while maintaining highly proficient assessment skills and critical thinking in the immediate postanesthetic period. Care for each patient is individualized with close collaboration from physicians and family members.

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Obstetric Department
Mother and baby care is the focus of attention in this department, which has been designed with sensitivity to women's needs. Our services are family oriented, with care centering on the physical and emotional well being of the family unit. The department's comprehensive services include prenatal and parenting classes, a breast feeding center and support programs such as RTS Bereavement Services.

• Labor/Delivery. While working in labor and delivery, you share the special joy of helping families welcome their babies into the world in the home-like LDR rooms. You will circulate for C-Sections as well as learn advanced techniques for managing high-risk and antenatal patients.
• Post-Partum Unit. In the post-partum unit, you will provide specialized care to the mother for the first few days after delivery. Patient education is an important part of the nursing care provided during this phase of the birth experience.
• Nursery. The nursery nurses care for the baby in the nursery until discharge. Through support and individualized education, you will be involved in assisting the family to care for the baby and prepare for discharge. Nursery nurses are expected to work in NICU and pediatrics.
• Neonatal Intensive Care Unit. Union Hospital's NICU provides specialized care to infants with life-threatening conditions. In addition to working with the most up-to-date equipment, you will support and instruct families by involving them in the care of their infants. NICU nurses are also expected to work in the nursery and pediatrics.

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Ambulatory Care
Union Hospital is a major provider of outpatient health care services to those patients requiring a short length of stay within the facility. Nursing practice includes special emphasis on patient education through individual and family teaching.

• Cardiac Rehabilitation. Registered nurses, with a sound cardiovascular knowledge base, collaborate with the cardiologists to develop and implement individual rehab programs for patients who have cardiovascular disease. The program may include stress testing, exercise, spouse support, smoking cessation, and/or education regarding disease process and risk factor reduction. Both inpatient and outpatient services are provided. Patients who have had a myocardial infarction or heart-related surgery are the typical clients.
• Family Practice Center. Union Hospital established its Family Practice Center and associated residency program with the goal of attracting more family physicians to the community and surrounding rural areas. Today nearly 2,000 families, representing all ages and backgrounds, receive primary care through the center. It is a model family practice for educating residents in the art and science of family medicine. The residency has recently introduced a rural training program and has developed a rural training site in Clay City, Indiana.
• Maternal Health. The clinic provides maternity care to the women of the Wabash Valley on a sliding fee scale basis. The multidisciplinary team includes nurses, physician assistant, nurse midwife, social worker, care coordinator, substance abuse counselor, nutritionist, family practice resident physicians, and family practice and obstetric faculty. Quality care is provided through direct patient assessment, counseling and teaching.
• Emergency. The emergency department treats nearly 42,000 patients a year. The department consists of four trauma rooms, the ability to centrally monitor a total of 12 patients, two OB/GYN rooms, three observation suites, two designated pediatric rooms, six fast-track bays, two ENT/eye rooms, four general treatment rooms, one negative pressure room and a designated triage. The department is equipped with state-of-the-art computerized documentation. We are a teaching facility that provides preceptors for physicians, nurse practitioners, paramedics, basic, intermediate and advanced medical technicians and registered and licensed nursing programs, as well as area high school students in the Health Career Program.
• Ambulatory Care Unit. This unit provides 24-hour medical and surgical nursing care for outpatients needing observation while awaiting diagnosis, following surgery, and for patients having special procedures such as cardiac catheterization and blood transfusions.
• Pain Clinic. The clinic provides care for acute and chronic pain patients on an outpatient basis. The clinic is open Monday through Thursday, 8 a.m. to 5 p.m. Assessment and evaluation of the patient is completed at each visit and includes education regarding procedures, medications and treatment.

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