Nursing

Barnesville Hospital's Nursing unit is, of course, the largest department in the hospital. The Nursing department consists of several units:

• Critical Care Unit
• Coronary/Intensive Care Unit (ICU)
• Emergency Room
• Medical/Surgical Unit
• Outpatient Department
• Surgery
• Cardiac Rehabilitation
• Pulmonary Rehabilitation

The Critical Care Unit, commonly known as CCU, is dedicated to providing specialized, intensive observation and care for patients of any age with cardiovascular, respiratory, or other medical and/or surgical problems. The scope of services offered by the unit includes, but is not limited to, monitoring of the individual client's condition and vital signs, as well as the following:

• Monitoring:
  • Blood Pressure
  • Apical Pulse
  • Arterial Line
  • Central Venous Pressure
  • SaO₂
  • ECG via Telemetry & Bedside Monitoring
  • Neurological Activity
  • Hourly Urinary Output
• Treatments:
  • Continuous Oxygen
  • Mechanical Ventilation
  • Bi-Pap Mask
  • Chest Tubes to Water Seal
• Medications:
  • Intravenous Anti-Arrhythmic Infusion
  • Intravenous Vaso-Pressive Infusion
  • Intravenous Infusion of Vaso-Dilating Drugs
  • Concentrated Potassium Drip (Mixed by Pharmacy)
  • Intravenous Anticoagulants
  • Infusion of Thrombolytics
  • Intravenous Infusion/Administration of Anti-Hypertensive Drugs
  • Infusion of Platelet Aggregator Drugs
  • Infusion of Aggrastat
• Procedures:
  • Pacemaker - external, temporary, or permanent
  • Cardioversion
• Assessments:
  • System assessments, along with a pain assessment, will be completed at least every four hours for CCU-ICU patients.

The following seven diagnoses have been identified as the most frequent admission diagnoses:

1. Myocardial Infarction
2. Congestive Heart Failure
3. Unstable Angina
4. Chronic Obstructive Pulmonary Disease
5. Gastrointestinal Bleeding
6. Cardia Arrhythmias
7. Diabetes Mellitus and Diabetic Ketoacidosis

The CCU is located on the first floor of the hospital, near the Med/Surg unit, and consists of 5 critical beds. There is a nurse's station inside the unit that is staffed with all personnel necessary for quality patient care 24 hours a day. Visiting hours for CCU are from 8:00Am to 8:00PM: however, permission from the nurse's station must be obtained prior to entering the unit.

The Emergency Room is available to provide care to patients in need of immediate medical assistance, 24 hours a day. The E.R. is located on the first floor, in the west wing, at the front of the hospital. E.R. has its own entrance which is very clearly marked as E.R. It houses two individual patient rooms and a pelvic room with two additional beds adjacent to the Emergency Department. The waiting area is located in the Registration area, a few meters down the hall. For safety, this waiting area is monitored by closed-circuit cameras 24 hours a day.

Upon discharge, the patients and family are educated, orally and written, in discharge instructions with special consideration to physical needs, age, support system, feelings, cultural/religious practices, ability to understand, etc.

The Medical/Surgical Nursing Unit (AKA "North") is located in the North Wing of the hospital, on the first floor. It has a total capacity of twenty patients. Each private room is equipped with a sink and an individual closet space. A separate cubicle with a commode is located in each room. One room is equipped with negative airflow to facilitate the needs of patients requiring respiratory isolation. The unit also accomodates skilled nursing patients.

• Internal Medicine
• General Surgery
• Urology
• Pulmonary Medicine
• Cardiology
• Neurology
• Podiatry
• Orthopedics
• Pain Management
• Hematology/Oncology
• OB/Gynecology
• ENT

• Chronic, Obstructive Bronchitis
• Congestive Heart Failure
• Pneumonia
• Coronary Artery Disease
• Dehydration

• Administration of IV
• Biopsy
• Thoracentesis
• Paracentesis
• Tensilon testing
• Lumbar puncture
• Bone Marrow

Outpatient is open Monday through Friday with flexible hours to accomodate patient needs. Normal hours of operation are from 6:45AM to 3:15PM, excluding holidays. If a patient is not ready to be discharged by 3:15PM, they will be transferred to the Medical/Surgical Unit, or kept on the Outpatient department with appropriate staff until discharge or transfer criteria is met.

To be considered eligible for placement and surgery in the Outpatient Department, a patient must be capable of receiving and following specific instructions and be motivated both physically and mentally. Patients requiring emergency service will only be scheduled in Outpatient surgery if the patient is stable and able to go home post-operatively.

Pre- and post-operative instructions will be given to all outpatient surgery patients. These instructions will be given to the patient by the surgeon and/or registered nurse. The original will go with the patient and a copy will be placed in the patient's medical record. When applicable, the following additional material may be placed in the patient's medical record:

1. Signed consent of admission
2. Signed consent form for procedure intended
3. Anesthesia Evaluation and Documentation
4. H&P
5. Completed surgical checklist
6. Laboratory & testing results
7. Pre-op nursing evaluation
8. Operating Room record
9. PACU record
10. Physician's order sheet
11. Progress notes
12. Post-op assessment record
13. Discharge instructions

The department is located on the second floor of the hospital, adjacent to the Surgical area. Nineteen beds are readily available. In addition, there is a room utilized for minor outpatient surgery not requiring the full Operating suite.

The top five admission reasons are: EGD, Colonoscopy, dermia repair, Laparoscopic Chole, and Cataracts. Outpatient services are supported by almost all other hospital departments.

The Operating Room suites are located on the second floor, occupying the west corner of the building. Standard hours of operation are 6:45AM to 3:15PM, Monday through Friday, excluding holidays. Patients of the O.R. are of all ages.

• General Surgery
• Gastroenterology
• Gynecology
• Podiatry
• Orthopedics
• Urology
• Opthamology
• Pulmonary
• Anesthesiology
• ENT

1. Endoscopies, Cystoscopies, Bronchoscopies, Colonoscopies, Gastroscopies
2. Laparoscopic Procedures
   1. Lap Chole
   2. Tubal Ligations
3. Arthoscopies
4. Breast Biopsies
   1. Excision
   2. Simple Mastectomies
   3. Quadrantectomies
   4. Radial Mastectomies
5. Appendectomies, Hernia Repairs, Bowel Cases
6. I&Ds, Skin Excisions (lipomas, lesions, etc.)
7. Cataracts - Eye Muscles
8. Orthopedics

The Cardiac Rehabilitation Unit is open Monday through Friday, 7:00AM to 5:00PM. A patient must have been referred to Cardiac Rehab by a physician. Once the paperwork is obtained and verified as appropriate, the Cardiac Rehab staff schedules the patient for an evaluation. After the initial evaluation, the patient is then scheduled for a class time and starting date.

Patients are seen in groups of up to four per class. Classes meat Monday, Wednesday, and Fridays between the hours af 8:00AM and 4:00PM, for sessions that are approximately one hour in length. A patient may continue attending the classes until their goals are met or he or she has reached 36 sessions.

Patients are monitored constantly and EKG (Electrocardiogram) strips are printed for every occurrence. Heart rates and blood pressures are recorded frequently, along with MET levels achieved. Patient's trends are printed periodically and are sent to the physician, along with a progress report. Blood glucose monitoring as available for diabetics and SPO₂ is available for patients suffering from lung disease.

Currently, Cardiac Rehabilitation accepts patients with a diagnosis of myocardial infarction within the past 12 months, stable angina, or coronary bypass graft within the past 12 months. These diagnoses are covered by Medicare and most insurance companies. Other diagnoses may also be covered, but must be pre-approved before admission into the program.

Patient education occurs through weekly classes held on nutrition, energy conservation, stress management, smoking cessation, medical usage, body composition analysis, stretching and flexibility, THR and pulse taking, diabetes, lab values, vitamins, and cardiac anatomy.

The treatment room is equipped with 2 Quinton treadmills, a Quinton telemetry unit (with Qtel computer system), a Monark stationary bicycle, Schwinn Airdyne bicycle, Monark upper body ergometer, Stratus recumbant bicycle, and two Nustep recumbant steppers. Additional equipment includes therabands, exercise mats, and various hand weights.

Cardiac Rehab is located on the first floor of the hospital, by Medical/Surgical and Rehabilitation Therapies.

The Pulmonary Rehabilitation Department is open Monday, Wednesday, and Friday, from 1:00PM to 4:00PM. A patient must have been referred to Cardiac Rehab by a physician. Once the paperwork is obtained and verified as appropriate, the Cardiopulmonary Rehab nurse schedules the patient for an evaluation. Then the patient is entered into a class. These classes have up to four patients per class, and they meet three times a week for approximately 1 to 1.5 hours each. A patient may continue this class until his or her goals have been met, or up to 24 sessions.

The patients' heart rates, blood pressures, oximetry monitoring, and blood glucose (for diabetics) are recorded frequently, along with MET levels and RPDs achieved. Patient trends are printed periodically and sent to the physician, along with a nurse's assessment of the patient. Blood glucose is monitored and recorded before & after each exercise. EKG recording available upon request by physician.

Appropriate diagnoses for entry into the outpatien pulmonary rehabilitation program may include, but are not limited to:

• Emphysema
• Reactive Airway Disorder, Asthma
• Chronic Bronchitis
• Cystic Fibrosis
• Bronchiectasis
• Interstitial, Occupational, or Environmental Lung Disease
• Pneumoconiosis
• Sarcoidosis
• Lung Resection

Patient education occurs with each session: a multidisciplinary team of Social Services, Dietary, Pharmacy, and Caridopulmonary services give education for 1/2 hour between the two classes, allowing both groups to conveniently attend.

The treatment room is equipped with 2 Quinton treadmills, a Quinton telemetry unit (with Qtel computer system), a Monark stationary bicycle, Schwinn Airdyne bicycle, Monark upper body ergometer, Stratus recumbant bicycle, and two Nustep recumbant steppers. Additional equipment includes therabands, exercise mats, and various hand weights.

Pulmonary Rehabilitation is located on the first floor of the hospital, by Medical/Surgical and Rehabilitation Therapies.