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Nursing Unit Descriptions – Fargo Region

Title
Location
Children's Hospital

A 33-bed Level III NICU. The nurse ground/air transport team that functions out of NICU brings in approximately 30% of the infants admitted to the NICU. Conditions of the infants can include prematurity, sepsis, respiratory distress, surgical emergencies, birth-related trauma and other medical conditions. RNs, Neonatal Nurse Practitioners and Neonatologists work in collaboration to provide direct care to infants.

Sanford Children’s NICU offers an advanced level of equipment and capabilities not found at every NICU, including:

  • synchronized intermittent mandatory ventilation
  • sophisticated pulmonary functioning testing
  • high frequency oscillatory ventilation
  • nitric oxide therapy
  • cool cap system

Staff Mix

RNs provide care to the intensive care infants as well as the other levels of care. Additionally, some are trained to function in the flight nurse role and provide transport services to the region. Respiratory therapists also staff the NICU at all times, providing respiratory care and direct patient care, including going on select transports with the RN flight nurse. Neonatal Nurse Practitioners are on site 24/7.

Nurse - Patient Ratio

1:1-3 (based on the three levels of care and acuity)

A 6-bed unit that admits children’s of all ages with diagnoses of trauma, cardiac disease, neurologic and neurosurgical problems, general surgery, acute life-threatening illnesses, multisystem failure and trauma related to child abuse, etc. Technology-dependent children are also hospitalized in this unit when ill.

Staff Mix

RNs and Unit Clerks

Nurse - Patient Ratio

All shifts - 1:1-2

An 18-bed unit that cares for children of all ages with acute and chronic diagnoses of all types. There is great diversity in patient types ranging from general surgery, cardiology, oncology, endocrine, GI, neurology, neurosurgery, medical, infectious disease, etc. This unit also has a sedation center program for children having procedures requiring conscious sedation, a brain injury program, a pediatric oncology program, and other specialized program models. Family-centered care is the philosophy of care.

Staff Mix

RNs, LPNs, Nursing Assistants, Unit Clerks and Child Life Specialists

Nurse - Patient Ratio

Days and evenings - 1:3
Nights - 1:4

Critical Care Cluster

A 19-bed unit serving post-cardiac surgery patients, acute MIs, post-PTCA/stent, heart failure, post-cardiac arrest, pulmonary and medical and surgical patients. Care also is provided to those patients requiring intra-aortic balloon pump therapy, impella and VADs.

Staff Mix

RNs, Nursing Assistants, Unit Clerks and Nurse Interns during the summer months.

Nurse - Patient Ratio

All shifts: 1:1-3

A 26-bed unit that provides the most advanced intervention and therapy for life-threatening illness or injury in adults. These patients require critical nursing intervention, assessment skills, monitoring, and/or advanced technological support for an illness, disease or injury. The patient population consists of trauma, kidney/pancreas transplant, pulmonary, neuro medical and surgical patients.

Staff Mix

RNs, Nursing Assistants and Unit Clerks

Nurse - Patient Ratio

All shifts - 1:1-2

The ICU Resource Team is comprised of RN’s designated to provide care for patients experiencing a multitude of symptoms from intensive to medical/surgical acuity levels in the two adult ICUs and medical/surgical units, including Cardiac Progressive Care, Neuro/Stroke or the MEdical Surgical Unit. ICU Resource Team staff are assigned on a shift-by-shift basis to inpatient nursing areas based in need and acuity of patients.

Staff Mix

RNs only

Nurse - Patient Ratio

Based on unit need and acuity of patient

Emergency Services

AirMed provides air transport for critically ill or injured patients of all ages and include a special neonatal team. Transports occur from referral hospitals via helicopter, fixed-wing ambulance to Sanford Medical Center or other medical centers. AirMed also transports from accident scenes via helicopter to Sanford Medical Center. RNs must be certified in ACLS, PALS, PHTLS, EMT and have audited an ATLS course. Orientation includes education on specialized equipment utilized in rotor-wing and fixed-wing aircraft.

Staff Mix

The transport team generally consists of one RN and one flight paramedic. Occasionally the mix is varied dependent on the nature of the flight (OB or neonatal).

Nurse - Patient Ratio

All shifts: 2:1

A Level II Trauma Center, the Sanford Emergency Center provides 24/7 care to 60,000 patients per year. Services include a Sexual Assault Nurse Examiner Program for adult and pediatric patients, case management and a nitrous oxide program for the pediatric population.

Staff Mix

Staffing is based upon Emergency Nurses Association Guidelines for nursing staffing in the Emergency Center. Nursing staff is composed of RNs, NAs and Unit Clerks. Emergency Center physicians are on duty 24/7.

Nurse - Patient Ratio

1:2-5

Kidney Services

Dialysis – Fargo is a 32-station outpatient dialysis unit providing outpatient dialysis and peritoneal dialysis training and monitoring for patients with Stage 5 kidney disease.

Dialysis – Detroit Lakes is a 15-station unit, providing outpatient hemodialysis 6 days per week.

Dialysis – Bemidji is a 12-station outpatient unit providing outpatient hemodialysis 6 days per week.

Dialysis – Morris is a 6-station unit providing outpatient hemodialysis on Monday, Wednesday and Friday.

Dialysis – Red Lake is a 6-station unit providing outpatient hemodialysis 6 days per week.

The Inpatient Dialysis team works very autonomously within Sanford Hospital in Fargo to provide the following treatment to hospitalized adults with limited services for children:

  1. Hemodialysis
  2. Peritoneal Dialysis
  3. Continuous Renal Replacement Therapy
  4. Apheresis treatments including WBC depletion
  5. Transplant services for kideny and pancreas

Staff Mix

The team consists mostly of RNs with LPNs and a CCHT. This team also covers Vibra Health (formerly SCCI), Psych, Rehab and Orthopedics at the South University Hospital.

Nurse - Patient Ratio

Not specified

Medical/Surgical Inpatient Cluster

A 25-bed inpatient unit serving cardiovascular medical and surgical patient populations such as those with unstable angina, post MI, rule out MI, cardiac bypass and valve repair/replacement, thoracic procedures, cardiac catheterization, post intervention, electrophysiology procedures, device implants, arrhythmias, cardioversion and heart failure. A long-range monitoring service is located on this unit.

Staff Mix

RNs, LPNs and Nursing Assistants

Nurse - Patient Ratio

Days - 1:3-4
Evenings - 1:3-4
Nights - 1:5

A 27-bed inpatient medical/respiratory unit. The patient population served includes a wide variety of diagnoses such as patients with pneumonia, COPD, respiratory distress, exacerbation of asthma, cellulitis, GI bleed, infections, rule out stroke (CVA), diabetes, detox, and many more. Primary Nursing is the model of care provided for the patients.

Staff Mix

RNs, LPNs and Nursing Assistants

Nurse - Patient Ratio

Days and Evenings - 1:3-4
Nights - 1:5-6

A 38-bed unit serving medical, nephrology, urology, kidney/pancreas transplants and progressive care ventilator patients.

Staff Mix

RNs, LPNs and Nursing Assistants

Nurse - Patient Ratio

Days and Evenings - 1:3-4
Nights - 1:4-6

A 19-bed unit specializing in neuro/neurosurgical patient. Patients may be admitted for elective or non-elective care such as elective neck and back surgery, brain surgery, spinal cord injury, trauma, stroke, brain injuries, Guillain Barre, seizures and back pain.

Staff Mix

RNs, LPNs and Nursing Assistants

Nurse - Patient Ratio

Days and Evenings - 1:3-4
Nights - 1:4-6

A 21-bed unit specializing in care of people who require observation for short periods of time to determine further treatment or establish a diagnosis. Patients in "observation status" consist of a wide variety of symptoms/diagnoses. Patients in "outpatient procedural" status, including cardiac and surgical procedures are also sent to this unit.

In addition, the Observation Unit includes a 5-bed unit specializing in the care of patients who require frequent blood products, IV antibiotics, fluid and electrolyte replacement, hydration, etc., or patients who require a bone marrow biopsy or kidney biopsy.

Staff Mix

RNs, LPNs and Nursing Assistants

Nurse - Patient Ratio

Days and Evenings - 1:3-4
Nights - 1:5

A 32-bed unit that specializes in the care of adult patients at various stages of cancer, including those in the process of diagnosis, treatment, experiencing side effects of treatment, palliative care and terminal care. Medical patients also are cared for on this unit.

Staff Mix

RNs, LPNs and Nursing Assistants. One RN works in the Chemotherapy Nurse Role.

Nurse - Patient Ratio

Days - 1:4
Evenings - 1:4-5
Nights - 1:5-6

A 28-bed unit specializing in Orthopedic and surgical care. Patients are admitted for elective Orthopedic, and some non-elective and surgical care, such as total joint replacement, arthroscopy, laminectomies, eye surgeries and any same day surgeries that need short term in-patient care for issues like pain management and nausea.

Staff Mix

RNs, LPNs and Nursing Assistants

Nurse - Patient Ratio

Days and Evenings - 1:4-5
Nights - 1:6-7

An 8-bed unit located at the South University Campus that focuses on relieving suffering and providing the best quality of life for patients with life-limiting illness. Palliative care provides intense symptom management in an acute care setting. Patients are often transitioning from aggressive curative care to a focus on comfort and symptom management. About 60% of patients are on the unit for end-of-life care.

Staff Mix

RNs, LPNs, Nursing Assistants

Nurse - Patient Ratio

All shifts: 1:4

A 27-bed collaborative practice environment for a CARF accredited program for both general acute rehabilitation and brain-injured patients. Admissions to this inpatient unit experience functional and cognitive disabilities as well as ongoing medical management occurring as a result of stroke, brain injury, spinal cord injury, neurological disease, fractures, total joint replacement and de-conditioning from a variety of events, and require minimally three hours of therapy per day in speech, occupational and/or physical therapy.

Staff Mix

RNs, LPNs and Nursing Assistants

Nurse - Patient Ratio

Days and Evenings - 1:4-5
Nights - 1:7-8

The Resource Team is comprised of RNs, CNAs and Constant Observers who work throughout Sanford’s two hospital locations in Fargo. RNs are hired to work a cluster of adult inpatient medical/surgical units and are cross-trained to other specialty areas. Nursing Assistants and Constant Observers work throughout the adult inpatient areas of the hospital. Resource Team staff consist of full and part-time employees that are assigned to various units on a shift-by-shift basis based on unit need.

Staff Mix

50% RNs, 45% Nursing Assistants and 5% Constant Observers

Nurse - Patient Ratio

As determined by unit

A 48-bed unit providing surgical care for general (gastric, esophageal, bowel, mastectomy), colon (including ostomy, resections), vascular (inclusing femoral/popliteal, carotid endarts), interventional radiology, ENT, bariatric, GYN, breast, oral-maxillary/facial and trauma patients.

Staff Mix

RNs, LPNs and Nursing Assistants

Nurse - Patient Ratio

Days - 1:3-4
Evenings - 1:4-5
Nights - 1:5-6

Obstetrics/Gynecology

A 34-bed unit with 2-bed triage area and additional overflow capabilities to accommodate a fluctuating census. This unit cares for patients who are antepartum, during labor and delivery, and postpartum. There is also an operating room and recovery room on the floor. The OR suite is staffed by Family Birth Center and OR staff for cesarean sections and post delivery procedures. All rooms are equipped with an emergency call system to the Neonatal Intensive Care Unit (NICU). Labor nurses are trained to circulate in the OR and PAR to maximize continuity of care. Family Birth Center has a trained flight team that provides regional AirMed services. The patient population includes high and low-risk antepartum, intrapartum and postpartum women and their well newborns.

Staff Mix

RNs, LPNs and Nursing Assistants.RNs care for all labor patients, are the circulating and PAR nurse for the FBC OR.LPNs are trained as scrub nurses in the OR and are included along with the CNAs to provide care to postpartum moms and babies. Assignments of postpartum patients include both the mom and baby.

Nurse - Patient Ratio

1:3-4 for postpartum and newborns (3-4 couplets)Labor patients are staff according to perinatal guidelines and standards

A 12-bed unit serving post partum moms and babies, GYN surgical, breast and plastic surgical patients primarily. The HUGS infant security system offers around-the-clock protection for post partum patients. The unit was designed with input from women in the community and previous medical center patients. Unit rooms are large enough to provide ample and comfortable space for families and patients, and are decorated in a color palette that is calming and comforting.

Team members have the opportunity to navigate their day from one of two computers in the room and have most supplies within reach. An advanced call light system enables team members to know the needs of patients prior to entering the room as well as location of their team members and other disciplines that work to provide care. A team approach to care is provided by RNs and Nursing Assistants.

Staff Mix

RNs and Nursing Assistants

Nurse - Patient Ratio

1:4-5

Psychiatric Services

An 8-bed eating disorder unit for patients age 12 and older. This unit also includes a partial hospitalization program.

Staff Mix

RNs, LPNs, Nursing Assistants, Behavioral Health Techs

Nurse - Patient Ratio

All shifts: 1:4

The Behavioral Health Unit serves 24 adult patients with psychiatric illness. Patients are cared for by an interdisciplinary team consisting of the psychiatrist, nursing, social work, psychology, occupational therapy, therapeutic recreation and behavioral health technicians and aides. The patient is treated with group therapy as well as individual therapy and assessments. This unit provides acute care for the patient and facilitates treatment ongoing in the community. This unit also includes a partial hospitalization program.

Staff Mix

RNs, Nursing Assistants and Behavioral Health Techs

Nurse - Patient Ratio

Days and Evenings - 1:6
Nights - 1:7

Surgery

The Day Unit is a 29-bed unit that admits and discharges patients ages 17 and older. Patients cared for on this unit have scheduled elective surgical, interventional radiology and cardiology procedures. Pre-operative care includes IV starts and assistance to the anesthesiologist/CRNA.

Staff Mix

RNs, Nursing Assistants, Unit Clerks. RNs admit and care for patients post procedure and assist with cardioversions and tilt table procedures.

Nurse - Patient Ratio

1:3

Offers 13 state-of-the-art operating rooms utilizing advanced endoscopic technology, robotics, transplant services to include kidney and pancreas transplants, a neuro navigation system and hybrid room. The OR utilizes block scheduling for all specialties. Call teams include general, cardiovascular and ortho/neuro. Rotating shifts encompass call with 24/7 shift coverage.

Staff Mix

RNs, Surgical Technicians, RN First Assist (RNFA) and call teams

Nurse - Patient Ratio

RNs: 1:1
Surgical Technicians: 1:1 - 2:1

Offers 10 operating rooms serving patients that require elective orthopedic and outpatient surgery. Block scheduling for all specialties is utilized. Outpatients are generally able to go home four hours after their procedure is completed. An Eye Center with 2 operating rooms is located across the street.

Staff Mix

RNs, Surgical Technichians, Unit Clerk, and Nursing Assistants

Nurse - Patient Ratio

RNs: 1:1
Surgical Technicians: 1:1 - 2:1

OSC is a hospital-based ambulatory surgery center that performs outpatient procedures, primarily orthopedic, ENT and hand cases. OSC has 4 operating rooms, an admitting area, first phase recovery area, second phase recovery/discharge area and instrument processing area.

Staff Mix

RNs (ACLS/PALS certified), Surgical Technicians, LPNs, Unit Clerks and Nursing Assistants

Nurse - Patient Ratio

Not specified

The Post Anesthesia Care Unit, PACU, is a 14 station unit adjacent to the Operating Room Suite.

The PACU RNs are ACLS and PALS prepared with ICU experience. They provide care to surgical patients of all ages and all surgical specialties. The staff also provide post-procedural care for Interventional Radiology patients and other patients that have had anesthesia or sedation for a procedure or diagnostic test.

Staff Mix

RN, Nursing Assistant, and Unit Clerk

Nurse - Patient Ratio

1:1-3

The PACU is an 11-station unit that provides post-procedural and post-operative care to patients of all ages who have had surgical procedures. A separate pediatric PACU with 8 stations is also available.

Staff Mix

RNs with ACLS/PALS certification are employed in the Day Unit and PACU areas. Unit Clerks are also on staff.

Nurse - Patient Ratio

1:2-4

Elective outpatient surgical center for patients from 3 months to the elderly. Includes 7 admission rooms, pediatric admission area, 4 operating rooms, an adult PACU with 8 bays, a pediatric PACU with 2 bays and a Phase II recovery with 6 bays.

Staff Mix

RNs, Nursing Assistants, Surgical Technicians and Unit Clerks. RNs care for the patient from admission to OR, PACU and Phase II area.

Nurse - Patient Ratio

1:2 Admissions, PACU, Phase II
1:1 Operating Room

Serves patients that require elective Orthopedic and outpatient surgery. The outpatients are generally able to go home four hours after their procedure is completed.

Staff Mix

Not specified

Nurse - Patient Ratio

Not specified