Nursing Unit Descriptions – Fargo Region

ASK-A-NURSE nurses use the nursing process as a framework to provide care for individual client populations over the phone 24 hours/day, 365 days/year. Ask-A-Nurse uses a totally computerized database of clinical algorithm designed guidelines to assess caller needs, prioritize the urgency, develop a plan of care and evaluate outcomes. All RN staff provide telephone triage to callers in ND, MN and SD. Receptionists handle class registrations and assist with caller registration.

A 33-bed nursery with three levels of care – intensive, intermediate and recovery. The nurse ground/air transport team that also functions out of NICU brings in approximately 30 percent of the infants admitted to the NICU. The conditions of the infants can include prematurity, sepsis, respiratory distress, surgical emergencies, birth-related trauma and other medical conditions. Neonatal Nurse Practitioners work in collaboration with the Neonatologist to provide direct care for infants.

A six-bed unit that admits children of all ages with diagnosis 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.

A 22-bed unit which cares for children of all ages with acute and chronic diagnosis 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 Peds Oncology program, and other specialized program models. Family centered care is the philosophy of care.

The unit provides a wide range of outpatient services to infants through geriatrics in multidisciplinary clinics such as: child maltreatment diagnostic work, pediatric diabetes, adult and pediatric neurorehabilitation, spinal cord injury, myelosyplasia, downs syndrome, cerebral palsy, muscular dystrophy, child developmental evaluation and cystic fibrosis.

The ICU Resource Team is comprised of RN’s designated to provide care for the patient experiencing a multitude of symptoms. The ICU Resource Team will provide care in the two adult ICU’s, and one of the following medical surgical units; Cardiac Progressive Care Unit, Neuro Stroke Unit or the Medical Surgical Unit. The staff will provide care to patients at the intensive to general medical surgical acuity levels. ICU Resource Team staff will be assigned on a shift-by-shift basis to inpatient nursing areas based on unit need. Staffing ratios will vary depending on acuity of the patients.

A 27-bed unit, which provides the most advanced intervention and therapy for life-threatening illness or injury in adults. Patients cared for 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.

A 19-bed unit serving post-cardiac surgery patients, acute MIs, post-PTCA/stent patients and post-cardiac arrest patients. Care also is provided to those patients requiring intra-aortic balloon pump therapy and vasoactive drugs.

A Level II trauma center. The Sanford Emergency Center provides 24/7 care to 50,000-patients/year. Our services include a Sexual Assault Nurse Examiner Program for sexual assault adult and pediatric patients and the One Call program staffed 24/7 with an Emergency Center RN to accept calls from referring facilities to assist with transfer of patients to Sanford in Fargo.

Provides air transport to the critically ill or injured of all ages, and includes a specialized neonatal team. Transports occur from referral hospitals via helicopter, fixed-wing ambulance either back to Sanford or to other medical centers. In addition, LifeFlight transports from accident scenes via helicopter to Sanford. 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.

A 28-bed unit specializing in Orthopedic and surgical care. Patients are admitted for elective Orthopedic, and some non-elective and surgical care (i.e. 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).

A 28-bed inpatient medical/respiratory unit. The patient population served includes a wide variety of diagnosis such as: patients with pneumonia, COPD, respiratory distress, exacerbation of asthma, cellulitis, GI bleed, infections, rule out stroke (CVA), diabetes, detox, and many more. Team Nursing is the model of care provided for the patients.

A 27-bed CARF accredited program for both general acute rehabilitation and brain-injured patients. Admissions to this inpatient unit suffer from functional and cognitive disabilities 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.

48 bed unit providing surgical care for general (gastric, esophageal, bowel), colon (including ostomy, resections), vascular (femoral/popliteal, carotid endarts, amputations), Interventional Radiology, ENT, bariatric, oral-maxillary/facial, trauma patients, plastic/reconstructive, Orthopedic and Intermediate patients.

An 8-bed unit located at the South University Campus. Palliative care is aggressive comfort care without prolongation of life, emphasizing improved quality of life. This unit is dedicated to the care of adult patients at the end of life in a supportive, comfortable and dignified environment for patients and families.

An 18-bed unit specializing in caring for people who require observation for short periods of time to determine further treatment or establish a diagnosis, as well as outpatient procedural patients. The nursing staff implemented many creative approaches, based on feedback from patients and the concepts of Relationship Based Care. The unit has all private rooms and the patient population is highly variable. Typical patient population includes: Cardiac procedure, chest pain, abdominal pain, fluid imbalance and surgical outpatient procedure patients.

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. The long range monitoring service is also located on this floor.

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.

A 19-bed unit specializing in neurologic care. Patients are admitted for elective or non-elective neuro-surgical care for neurological events such as stroke, brain injury, seizures, multiple sclerosis, Guillain Barre, weakness, back pain, etc.

A 40-bed unit serving medical, nephrology, urology, kidney/pancreas transplants and progressive care ventilator patients.

A 32-bed unit with three-bed triage area and additional overflow capabilities to accommodate a census of 34 patients. The unit had 21 LDRPs (labor delivery recovery and postpartum). The other rooms are private antepartum and postpartum rooms. An OR suite is located on the unit and staffed by the Birth Center associates for a cesarean sections and post delivery procedures. All rooms are equipped with an emergency call system to the Neonatal Intensive Care Unit. Labor nurses are trained in circulating in the OR and PAR to maximize continuity of care. The Birth Center has a trained flight team that provides regional LifeFlight services. The patient population includes high and low risk antepartum, intrapartum and postpartum women and their well newborns.

The Psychiatric Unit has an average daily census of 16 cases with space to increase to 30 patients and cares for adult inpatients with primary psychiatric diagnosis. Psychiatrists are the admitting physicians and are part of the interdisciplinary team, which includes nursing, social service, case coordinators, occupational therapists and therapeutic recreation specialists. A new unit opened in April 2003, an eight-bed eating disorder unit for ages 12 and older. RNs and LPNs are a key part to the treatment team.

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.

The Resource Team is comprised of 180 RNs, LPNs, CNAs and unit clerks who work throughout Sanford's two hospital locations in Fargo. RNs and LPNs are hired to work a primary "cluster" of units (Intensive Care, Medical/Surgical) and are cross-trained to other specialty areas. Nursing assistants work throughout all of the inpatient areas of the hospital. Resource Team staff are assigned on a shift-by-shift basis to inpatient nursing areas based on unit need.

Dialysis – Fargo is a 22-station outpatient dialysis unit providing outpatient dialysis and peritoneal dialysis training and monitoring for patients with chronic kidney disease stage five. This unit also provides dialysis coverage for SCCI Hospital, and the TCU and Rehab units

Dialysis – Detroit Lakes is a 12-station hemodialysis unit, providing outpatient hemodialysis and is open six days per week.

Dialysis – Bemidji is a 12-station outpatient dialysis unit, providing outpatient hemodialysis and is open six days per week.

Dialysis – Morris is a five-station outpatient hemodialysis unit and is open six days per week and in November will be a six station unit.

Dialysis – Red Lake is a five-station outpatient dialysis unit, providing outpatient hemodialysis and is open six days per week.

The Inpatient Dialysis team works within Sanford Hospital in Fargo. This team is an all RN team who work very autonomously. They provide the following types of treatment to hospitalized adults and children:

1. Hemodialysis
2. Peritoneal Dialysis
3. Continuous Renal Replacement Therapy
4. Apheresis treatments
5. Charcoal Hemoperfusion

The Day unit is a 32 bed unit that admits patients ages 17 and older having elective surgical procedures, interventional radiology procedures and cardiac procedures. Post-procedural and post-operative. Care is also provided for outpatients. In addition, elective cardioversions and tilt table procedures are performed on the Day Unit.

State-of-the-art operating room facilities utilizing advanced endoscopic technology, robotics, transplant services to include kidney and pancreas transplants. 13 operating rooms, utilizing block scheduling for all specialties. Call teams include General, Cardiovascular and Ortho/Neuro. Rotating shifts that encompass call with 24/7 shift coverage.

Ten operating rooms. Block scheduling for all specialties is utilized. An Eye Center with two operating rooms is located across the street.

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

The Day Unit provides preoperative care for patients going to the operating room including IV starts and assistance to the anesthesiologist/CRNA. The PACU is a 11-station unit which admits patients of all age groups having surgical procedures. Post-procedural and postoperative care is provided. A separate pediatric PACU with 8 stations is also utilized.