Cardiac Catheterization Lab
The Cardiac Catheterization Lab is responsible for performing coronary angiograms, percutaneous coronary interventions, electrophysiology studies, radiofrequency ablations, pacemaker and defibrillator insertions. Nurses are primarily responsible for care of patients in the HEART Unit which is a 5 bed same-day area that provides pre- and post-heart cath procedure care. Nurses have opportunities for expanded experiences within the heart catheterization lab. These opportunities include assisting the circulating nurse with routine coronary angiograms, angioplasties and emergent cases. Additional experiences will include observing in the cardiotesting and exercise physiology departments and observing coronary artery bypass grafting surgery.
Cardiology and Cardiothoracic Surgery Clinic
The outpatient clinic has 16 exam rooms and serves more than 1,000 patients per month. Patients needs are met by the expertise of cardiologists, cardiothoracic surgeons, physician assistants, nurse practitioners, registered nurses, medical assistants and support staff. There are several specialties within the outpatient clinic including: general cardiology, arrhythmia and pacemaker clinic, congestive heart failure clinic, adult congenital heart disease clinic, cardiovascular disease prevention clinic, pediatric cardiology, electrophysiology and cardiothoracic surgery clinic.
A registered nurse or team of nurses is assigned to each cardiologist or surgeon and coordinates the care of his/her patients. The nurse is responsible for evaluating the patient’s health and educating about his/her medical condition, medications, tests/procedures and plan of care. The patient or family member can call the nurse with questions regarding the plan of care, tests, medications, lab results and/or symptoms. Each nurse has extensive experience in cardiac patient care and is able to answer questions in consultation with the cardiologist. All registered nurses have training in Advanced Cardiac Life Support and are prepared to respond to emergency situations that arise in the outpatient clinic setting.
Nurses on this fast-paced 29-bed medical surgical unit deal with most phases of cardiac disease. They emphasize rehabilitation, education and lifestyle changes or modification for patients. The patient population includes post-MI, post-open heart surgery, post-thoracotomy, pace-makers, pre-and post-angiography, post-cardiothoracic surgery and pulmonary patients, those who have suffered congestive heart failure and any med-surg patient needing telemetry monitoring.
Critical Care 2nd
Critically ill patients with multiple and diverse needs are cared for by nurses in this 15-bed unit. Nurses work with surgical (including open-heart), trauma, medical, overdose and neuro/neurosurgery patients. Nurses here find great rewards in rising to the challenges of this dynamic environment.
Critical Care 6th
This 18-bed unit is dedicated to the care of patients with MI, shock, arrhythmias, pacemakers, heart failure, active GI bleeds, detox and overdose. Nurses here find an excellent environment to concentrate on critical thinking skills, assessment of critically ill patients, clinical intervention and family support techniques.
Family Medicine (Decorah, Iowa, campus)
The Gundersen Decorah Clinic is a full scope family medicine clinic. Physicians deliver babies and see patients in area nursing homes. Surgeons perform procedures on site and at local hospitals. The Clinic has a full range of visiting specialist from La Crosse as well as on site Podiatry Services. About 250 patients are seen in the Clinic on a daily basis.
Float Pool/Hospital Clinic Operations
Gundersen Float Pool is home to Clinic and Hospital Registered Nurses, Licensed Practical Nurses, Certified Nursing Assistants, Certified Medical Assistants, and Health Unit Coordinators who care for a diverse patient population. Clinic float staff are oriented to departments ranging from Internal Medicine and Family Medicine to specialty departments such as Oncology, Cardiology, Pediatrics and Express Care. Hospital float staff orient to different hospital units such as Pediatrics, Medical Oncology, Orthopedics and Critical Care units. Regional float staff orient to several of the regional clinics, primarily in the family medicine arena. This highly-skilled team of healthcare professionals enjoy the wide variety of patients they care for and are constantly broadening their knowledge base.
GI Endoscopy Center
The GI Endoscopy Center has 7 procedure rooms and 20 pre/post procedure rooms in which we provide procedural services to our patients on an outpatient basis. We also have a fluoroscopy room, the Endosuite, that we share with Pulmonary to do any procedures needing fluoro or negative pressure. Nurses in the GI Lab perform pre-procedure assessment, start IVs, give conscious sedation, monitor the patient during the procedure and in recovery. All of this is charted in the EPIC electronic medical record. The nurses assist in procedures such as colonoscopy, EGD, ERCP and EUS and also complete discharge planning for patients. The staff also travel to critical care areas to perform procedures on patients in those units.
Hematology/Oncology - Adult (Center for Cancer & Blood Disorders, East Building 2nd floor)
The Center provides compassionate, comprehensive and multidisciplinary patient and family care. Nurses provide care to adults 18 years of age and older. The unit provides chemotherapy to an average of 20 patients per day. Learning opportunities for nurses include:
- Observation of chemotherapy administration
- Administering medications – p.o. subq, IM, IV
- Monitoring vital signs and status
- Assessing/observing disease-related symptoms and side effects of treatment
- Triaging phone calls
- Participating in multidisciplinary care conferences
- Placement of IV catheters
- Accessing central lines and assist with PICC line dressing changes
- Teaching patients
- Developing and utilizing critical thinking skills
Hematology/Oncology - Pediatric (East Building, 2nd floor)
The Pediatric Hematology/Oncology program offers a comprehensive multidisciplinary team approach to care for newborns to young adults and their families. Members of the team include physicians, APNP, nurses, social worker, marriage and family therapist, child life specialist, pastoral care and palliative care. The medical care is the most current and promising treatment available. This area is a member of the Children’s Oncology Group, the nation’s largest childhood cancer research coalition in which clinical trials are used to identify more effective treatment methods.
This group provides skilled end of life care for adults and pediatric patients within a 45-mile radius of La Crosse. The multidisciplinary team consists of nurses who provide skilled care such as manage symptoms for your comfort, social workers who provide support such as assisting with end-of-life planning, chaplains who work with all churches and spiritual leaders, bereavement coordinators who support, teach and offer resources to grieving family and friends, hospice aides who assist with personal cares and volunteers. All members of the multidisciplinary team work with patients of all ages. Hospice provides a holistic approach for patients and their caregivers on their journey to the end-of-life in the comfort of their home or residence. We also provide inpatient hospice for dying patients who wish to remain in the hospital, nursing home or assisted living facility.
IV Therapy is comprised of four areas providing care. Home infusion nurses instruct and support patients receiving IV medication or Enteral therapy in their homes. Acute practice nurses respond to the IV access needs of patients in the Hospital and Clinic. This practice also includes the placement of peripherally inserted central catheters (PICC lines). In the Ambulatory Infusion Center, patients are admitted to receive various IV infusions including blood products and medications. The team also provides apheresis care during which various blood components are removed and then replaced. IV Therapy is also responsible for educating nurses, medical students and other staff on IV therapy techniques and procedures.
Labor & Delivery
The New Life Family Center embraces family-centered care as their philosophy for providing care for families experiencing uncomplicated and high-risk pregnancies. Nurses collaboratively practice with obstetricians, certified nurse midwives and Family Medicine physicians to deliver about 1,500 babies a year. Staff on the 22-bed maternity unit care for women who have had vaginal or Cesarean deliveries, tubal ligations, antepartum complications and gynecologic surgeries.
Labor & Delivery consists of six rooms where families labor, deliver and recover with their baby in the same room. Two delivery/operating rooms are also available. There is a birth center, separate from the L&D area, where families labor, deliver and recover for their entire postpartum stay. Gundersen also performs water births. Nurses are cross-trained and work in Labor & Delivery and Postpartum. The newborn nursery staff is also trained to care for intermediate newborns needing a little extra special care, but don’t quite need to be in the NICU.
Medical & Oncology
Nurses on this 29-bed unit provide care for oncology/hematology patients receiving chemotherapy and radiation therapy. They also care for adults with acute and chronic medical problems that involve renal dialysis, gastroenterology, endocrinology, dermatology, medical pulmonary, infectious disease and geriatrics.
The Neuroscience Center consists of the departments of Neurosurgery, Neurology, Physical Medicine & Rehabilitation, Pain Medicine, Neuropsychology and Speech-Language Pathology. Within those departments there are multidisciplinary resources that support the nursing role and nursing practice. Nurses provide patient care through both telephone triage and nurse-only visits in the Clinic. The nurse-only visits include patient teaching, pre- and post-op teaching and management of surgically implanted devices. Over 4,000 nurse visits occur every year. The scope of practice for the RN in the Neuroscience Center is utilized to its full potential which makes it a very rewarding and gratifying place to work.
This 16-suite unit is staffed by nurses who assist in the performance of surgical procedures such as open heart, interventional, neuro, vascular, orthopaedic, otolaryngology, general gynecology, urology, DaVinci, trauma and plastic reconstructive. Nurses in this area provide care for outpatient as well as inpatient populations, in both the circulating and scrub roles.
This 32-bed unit offers a variety of learning experiences for nurses. Orthopaedic experiences include working with patients who may have fractures, joint replacements and major or minor trauma. Neurosurgical experiences include patients who have spinal surgeries, brain trauma and tumors. Other types include those with seizures and strokes. Teams are composed of RNs, CNAs and an Ortho Tech. Ratios are from 1:4 or 1:3 based on acuity.
Outpatient Surgery Center
The Outpatient Surgery Center has 6 operating rooms, 21 pre-op/post-op rooms and 8-post anesthesia care spaces. The unit is designed to provide surgical services to patients on an outpatient basis. Nurses admit patients on the day of surgery, care for them in the operating room, recover the patients from their surgical procedure and provide discharge teaching. The OR is staffed by registered nurses in the circulating role and surgical technicians. The pre/post-op areas are staffed by registered nurses and perioperative technicians. A certified child life specialist is also on staff to serve our pediatric patients. The Surgery Center serves patients as young as 6-months-old to 100+ years in a variety of surgical specialties including ophthalmology, otolaryngology, orthopaedics, plastics and podiatry.
Nurses on this 15 bed unit offer a unique nursing experience utilizing a multidisciplinary approach and a family-centered nursing care philosophy. Care is provided for infants through age 18 and adult overflow patients. This challenging unit serves patients with a wide variety of medical and surgical diagnoses providing individualized care, technical support and education to help ensure optimal health outcomes.
Pediatric/Neonatal Intensive Care Unit (PNICU)
The Pediatric Intensive Care Unit (PICU) is a four–bed unit where care is provided for newborns after discharge from the hospital, to young adults 18 years of age. Any child with a serious injury or illness requiring special monitoring and continuous observation by specially trained medical personnel will most likely be admitted to the PICU.
The Neonatal Intensive Care Unit (NICU) is for newborns who need close medical attention. The NICU combines advanced technology and trained healthcare professionals to provide specialized care for the tiniest patients. Most babies admitted to the NICU are premature, have low birth weight or have a condition that requires special medical or surgical care. Twins, triplets and other multiples are often admitted to the NICU, and babies with medical conditions such as heart and/or respiratory problems, infections or birth defects are also cared for in the NICU.
Although separate units, nursing staff in the PNICU care for PICU and NICU patients and their families.
Our unit provides care for inpatients and admission day surgical patients, along with patients that present for a same day surgery procedure. Our nurses complete the patient admission and education, while offering individualized care prior to surgery. For the same day surgery patients, we provide recovery care through to discharge.
Post Anesthesia Care Unit (PACU)
PACU is designed to provide short-term intensive care to patients during their immediate post-operative phase. Nursing staff continuously assesses each patient’s status and provide for maximum comfort and safety. If complications should occur, staff are trained and equipped to deal with them in an efficient, competent manner. Standards have been established to assure quality care to all. Discharge criteria must be met before a patient is transferred from the unit or discharged home.
Psychiatry, La Crosse campus
Inpatient Psychiatry is a 24-bed unit where patients are treated for all mental health concerns. The multidisciplinary team of psychiatrists, Nurse practitioners, nurses, CNAs, social workers, occupational therapists, recreational therapists, clergy and chemical dependency counselors work with patients of all ages, adolescent through geriatric. Nurses are involved in groups and individual contacts. This unit works closely with many agencies in the area and performs active disposition planning.
The Radiation Oncology department is part of the Center for Cancer & Blood Disorders. As an outpatient treatment center, Radiation Oncology uses high energy x-rays to treat cancer. An interdisciplinary care team, including MDs, RNs, Medical Assistants, Radiation Therapists, Radiation Physicists, Dosimetrists, social workers, dieticians, palliative care services, family counselors, pastoral care and hereditary cancer services work together to provide the best medical care with the latest technology. Multiple treatment modalities are provided — external beam radiation, intensity modulated radiation therapy, image guided radiation therapy with cone beam CT and stereoscopic x-ray guidance, stereotactic radiosurgery, stereotactic radiotherapy, intracavitary brachytherapy, partial breast radiation, including MammoSite, Prostate Seed Implants. The nurses in this area are professionally trained to provide ongoing education, consistent hands-on patient care to manage treatment side effects and provide emotional and physical support.
Inpatient Rehabilitation provides personalized, compassionate care for patients with physical disabilities due to trauma or illness. Carefully planned interdisciplinary programs help patients regain or maximize ability to function at home, at work and in the community. This 16-bed unit offers a setting for nurses to promote independence through involvement with patients, families and a multidisciplinary rehabilitation team. Caseloads include patients affected by brain injury, CVA’s, spinal cord injury arthritis, demyelinating disease, amputations, fractured hips, multiple sclerosis and Parkinson’s disease.
Renal Dialysis uses a interdisciplinary team approach to care for patients with chronic end-stage renal disease as well as patients with acute renal failure, both on an outpatient and in-patient basis. The 12-station hemodialysis unit in La Crosse provides services to more medically unstable chronic outpatients, all new dialysis patients and any satellite patients experiencing temporary problems. This unit is open Mondays, Wednesdays and Fridays. Nursing staff is available 24/7 to provide treatments at the bedside for hospitalized patients. Outpatient hemodialysis is provided at the 30-station Onalaska Renal Center Mondays through Saturdays. We also have smaller satellite hemodialysis units located in Prairie du Chien, Tomah, Viroqua, Black River Falls with the anticipation of a unit opening in Richland Center in the future. Our home peritoneal dialysis (PD) program is also very active, usually serving from 25-30 Home patients and based on 2 South next to the hemodialysis unit.
Short Stay Unit
The Short Stay Unit provides care to planned outpatient procedure or outpatient surgicals who require continued recovery time in a hospital bed. Most of these patients discharge the same day. Some patients stay overnight until their recovery care meets criteria for discharge. The unit also admits a wide variety of unplanned admissions who need Observation care. This can be cardiac to a wide variety of medical diagnosis patient types. The unit is brisk with rapid turnover of patients and has staff who are skilled in caring for a wide variety of patients in the most efficient manner.
The interdisciplinary care team on this 34-bed unit provides care for a wide variety of people including trauma, abdominal, vascular, urology, otolaryngology, Bariatric and plastic surgery patients. Patient education, discharge planning and pain control are important components of the nurse’s role. Nurses frequently work with IVs, hyperalimentation, NGs, trachs, patient controlled analgesic pumps, epidural catheters, drains, foleys, telemetry monitoring, wound vacs, and simple or complex dressing changes.
Trauma & Emergency Center (ER)
Nurses in this 18-bed unit provide care to patients with a wide variety of physical and emotional needs. Nurses are part of a multidisciplinary team including emergency physicians and social workers. Patients cared for here have 24-hour access to laboratory, X-ray and OR services.
This ambulatory care unit sees adult and pediatric patients with varying needs on a walk-in basis. Patient types range from respiratory illness to high acuity types such as MI’s. Nurses here learn a variety of procedures and skills including patient assessment and teaching. A few procedure and skills nurses provide are triage, IV rehydration, wound care, transferring patients to the ER and medication administration.