February 19, 2020

Where Do US Nurses Work?

There are various settings in which U.S. RNs work. A chart showing the full breakdown of work settings is pictured below. In this article we don't cover them all, but dive more deeply into a select few work settings and highlight the skills, requirements, and type of patient care that is administered in each.

Long-Term Acute Care Hospital (Also referred to as LTACs)

This hospital provides treatment to patients for severe injuries or episodes of illness, urgent medical conditions, or those recovering from surgery. This setting involves patients who will need treatment on average for greater than 25 days.

  • Requirements - BLS, ACLS (facility specific)
  • Skills � General nursing skills, assessment skills, EMR, wound care, wound vacs, pulmonary rehab, ventilators, tracheostomy care, total care, active and passive ROM exercise, burn management, restraints, seizure precautions, NG tubes, G-tubes, J Tubes, tube feeds, colostomy/ileostomy care, Foley catheter care, central line care, IV care, infusion pumps, administration of blood products, medication administration.
  • Most common issues patients have in this setting � Pneumonia, COPD, emphysema, TBI, spinal cord injury, stroke, MS, Alzheimer's, Parkinson's, ALS, Joint replacement, amputation, wound care, CHF, fluid and electrolyte imbalances, HTN.
  • Nurse qualities that are best fitting for this setting � teamwork, good communication skills between nurses and nurse to patient, interdisciplinary communication, time management, prioritization skills, delegation, physical assessment skills, documentation (EMR).

Short-Term Acute Care Hospital

This hospital is comprised of all the different hospital units and specialties all depending on the size and capabilities of the hospital. (Medical Surgical, Remote Cardiac Telemetry, ICU units, stepdown units, PACU, OR, Labor and Delivery, Mother Baby, Nursery, Dialysis, Endoscopy, and Emergency units.)

  • Definition � active and short-term treatment for illness or injury, post-surgical, and urgent care needs. Short term acute care hospitals aim to release patients as soon as they are stabilized.
  • Requirements -� all require a BLS certification. Requirements for this facility are unit specific will have different certification requirements. Critical care units require ACLS, possible TNCC.
  • Skills � Each unit requires different variations of skill sets.
  • (Remote Cardiac Telemetry)
  • (Medical/Surgical)
  • (Critical Care/ICU)
  • (Emergency Department)
  • (Post Anesthesia Care Unit)
  • (OR Scrub Nurse)
  • (OR Circulating Nurse)
  • (L&D, mother baby, nursery)
  • Nurse qualities that are best fitting for this setting - ability to adjust to fast pace environment, time management and prioritization skills, delegation, good nurse patient communication, professionalism and teamwork.

Home Healthcare

This is care provided in a patient's home by a certified healthcare provider (PT or RN) prescribed by a physician as part of the care plan usually following a hospitalization.

  • Requirements � BLS
  • Skills � general nursing skill sets, EMR, wound care, medication administration and medication knowledge. IV care, infusion pumps, PICC lines, Ports, IV medication administration, TPN, wound vacs, G/J-tubes, ostomy care, catheter care, tube feeds, tracheostomy care, assessment skills.
  • Most common issues patients have in this setting � hypertension, a-fib, CHF, COPD, post-op recovery, wound care, TBI, MS, Parkinson's, ALS, spinal cord injury, TIA, kidney disease, oncological patients, amputations, fractures, joint replacement, pneumonia.
  • Nurse qualities that are best fitting for this setting - time management, scheduling, planning, autonomy (comfortable working independently), driving in cities and rural settings with the use of a GPS system, documentation (EMR), professionalism, nurse/patient communication.

Psychiatric Hospital

This hospital focuses on the care and treatment of individuals with psychiatric disorders.

  • Requirements � BLS
  • Skills - general nursing skills, medications administration, restraints, conflict resolution, de-escalation.
  • Most common issues patients have in this setting � substance abuse, withdrawal, addiction, depression, bipolar disorder, anxiety disorder, schizophrenia, schizoaffective disorder, borderline personality disorder, anorexia nervosa, bulimia, suicidal, violent behavior, abuse victims.
  • Nurse qualities that are best fitting for this setting - nurse/patient communication, time management, prioritization, documentation, assessment skills, teamwork, and professionalism.

Long-Term Care Facility (LTC) / Skilled Nursing Facility (SNF)

This type of facility provides ongoing long-term skilled nursing care to patients (residents) and assists them with their daily living activities.

  • Requirements - BLS
  • Skills - medication administration, lab draws, IV medication administration, IV pumps, central lines, documentation, patient assessment, patient transfer equipment, tube feeds, ostomy care, catheter care, wound care.
  • Most common issues patients have in this setting - hypertension, pre/post MI, CHF, fluid and electrolyte imbalances, pneumonia, COPD, emphysema, TBI, stroke, Alzheimer's, dysphagia, pressure ulcers.
  • Nurse qualities that are best fitting for this setting - time management, prioritization, delegation, documentation, teamwork, professionalism, nurse-patient communication.

Feel free to reach out to your most current assigned PassportUSA representative if you have any questions about the settings in which our nurses work.Click here to view a U.S. Nursing Fun Facts Infographic!Be sure to check out more great articles in the Employee Education Center�to help you succeed in your new life in the USA!If you are not contracted with us and are interested in joining PassportUSA, register with us today!

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