A Time To Heal

After routine surgery, a 60-year-old woman with chronic obstructive pulmonary disease experiences a flare up. She spends two weeks in intensive care but is still on a ventilator.

A 35-year-old paraplegic develops pressure ulcers in addition to ongoing kidney problems. He needs extended bed rest and intravenous antibiotic therapy.

Both patients are too sick to be cared for on a regular hospital floor. But because they are stable, intensive care is no longer appropriate.

Meeting Complex Needs

Long-term acute care has evolved to meet the needs of patients like these. "We give them the time they need to recover," says Jeanne Clinton, a clinical nurse educator at Regency Hospital in Golden Valley. "On average, patients are here for about a month, but some stay as long as six or seven."

Patients come to the 53-bed facility from area hospitals, often directly from the intensive care unit. They may be recovering from multi-system failure, need to be weaned from ventilators or require continual cardiac monitoring.

Nurses work with only a few patients at a time. In the intermediate critical care unit, for example, each nurse cares for one or two patients. Nurses in the high observation unit care for three, and those in the medical/surgical unit care for four or five.

This kind of nursing is known as progressive care, and it is recognized as a specialty of critical care by the American Association of Critical-Care Nurses (www.aacn.org).

"The patients are complex, and their care is both challenging and satisfying," says Regency charge nurse Janet Griffitts. "And because they're here for a long time, you really get to know them and their families."

A Necessary Niche

Medical advances are enabling people to live with conditions that were once fatal. In addition, as the population ages, more people are developing diabetes, heart disease and other chronic conditions that can cause complications after surgery or other treatment.

As a result, the need for progressive care nurses is growing. "It's a very necessary niche," Clinton says. "And it's a great field to work in because you're able to see patient outcomes."