The Intermediate Surgical Care Unit (ISCU) provides specialized care for post-operative surgical patients requiring a level of support between intensive care and acute care. With a 1:4 nurse-to-patient ratio, the unit offers enhanced monitoring and clinical oversight for individuals recovering from complex surgical procedures. ISCU nurses are trained in intermediate-level interventions and collaborate closely with surgical teams, hospitalists, and ancillary staff to ensure safe transitions and optimal recovery. This unit emphasizes individualized care planning, interdisciplinary coordination, and vigilant assessment to support patients through critical phases of post-operative healing.

Provides compassionate personal care and support services under the supervision of a registered nurse or LPN.  Collaborates with nurses, physicians and other healthcare providers to oversee and monitor patients to support healing.

1. Receive RN report at start of shift
2. Walking rounds and shift report with off going PCA to ensure patients clean and dry/ rooms clean
3. Apply cardiac monitoring; Change all cardiac monitor batteries at 7am (on designated units?)
4. Document patient bedside rounds q2h (odd hours)
5. Conduct 4 P’s on every round: Pain, Position, Potty, Perimeter
6. Document patient vital signs q4h (or as ordered)
7. Daily Glucometer QC (Night shift)
8. Bathe patients daily (change for pts with central lines)
9. Replace EKG pads (cardiac monitor) daily with baths
10. Daily linen change
11. Assist patient with Activities of Daily Living (ADL) - ie. brushing/mouth care, feeding patient, assisting with toileting, etc.)
12. Obtain blood sugars on all diabetic patients and document
13. Stock isolation caddies in halls and rooms are stocked for next shift
14. Keep patient rooms clean and free from clutter (empty urinals, commodes, food, clutter, etc)
15. Empty trash from assigned rooms as needed and prior to change of shift
16. Answer call lights in a timely manner
17. Initiate or continue pressure ulcer bundle (consult with RN for Braden scores)
18. Turn/Reposition patients every 2 hours in bed or chair
19. Initiate or continue Fall Prevention protocol (see Unit Secretary for Morse Scores)
20. Weigh all patients on admission and every Wednesday at 5am (unless patient is a daily weight) standing scale preferred***
21. Prepare rooms for admission (admission bucket-bath basin, soap, kleenex, water pitcher, etc.)
22. Update patient whiteboards Daily.
23. Daily bath on night shift – DIALYSIS / Pre-Procedural patients
24. Fresh Ice given at 1700/0500 for start of next shift
25. Vital sign machines wiped down and stocked for next shift
26. Assists in orientation of new staff
27. Other duties as assigned
28. Measure and Record Intake/Output
29. Accurately documents care provided according to policies and procedures.
30. Applies safety principles when performing care such as ambulation of patients, transferring patients, assisting with normal range of motion, and positioning, and fall prevention techniques.
31. Participates in cost saving utilization of supplies

DCH Standards:

• Maintains performance, patient and employee satisfaction and financial standards as outlined in the performance evaluation.
• Performs compliance requirements as outlined in the Employee Handbook
• Must adhere to the DCH Behavioral Standards including creating positive relationships with patients/families, coworkers, colleagues and with self.
• Performs essential job functions in a manner that ensures the safety of patients, visitors and employees.
• Identifies and reduces unsafe practices that may result in harm to patients, visitors and employees
• Recognizes and takes appropriate action to reduce risks and hazards to promote safety for patients, visitors and employees.
• Requires use of electronic mail, time and attendance software, learning management software and intranet.
• Must adhere to all DCH Health System policies and procedures.
• All other duties as assigned.

Minimum Knowledge, Skills, Experience Required:

• Approved previous experience in giving patient care or completion of in-service education classes
• High school education or equivalent
• Must be able to read, write legibly, speak, and comprehend English.
• BLS required or achieved within first 90 days of employment.

WORKING CONDITIONS

Physical:  Physical presence onsite is essential.  Hearing and vision must be normal or corrected within normal range.  Able to perform duties with or without reasonable accommodation. Ability to tolerate prolonged periods of standing and walking.  Ability to lift and carry 50 pounds with frequent lifting and/or carrying of objects weighing up to 25 pounds.  Is able to push stretcher/wheelchair with average adult patient.  Is able to do frequent stooping and on occasion crouching, crawling or kneeling.  Ability to reach reasonable distances in any direction.  Ability to run in emergency situations.  Must be able to move fingers in a coordinated manner.  Must have ability to feel and perceive temperature, texture, shape and size with fingertips. 

Environmental:  Includes exposure to human body fluids, disease, infection, lab chemicals and hazard materials and/or cleaning solutions.  Requires wearing common protective or safety equipment.

Psychological:  Includes receiving delegation, working with team members, addressing conflict, and communicating with all types of personalities.