The two major criteria for admission to the NRCU are that patients require specialized respiratory monitoring and/or support, and that patients must be hemodynamically stable. The medical director, in conjunction with the nursing unit leader, assumes primary responsibility for triage of patients into and out of the NRCU according to the patients severity of illness and staffing requirements. Patients may be admitted directly to the NRCU or transferred to the NRCU from another unit within the hospital or from an outside institution. Transfers from our medical intensive care unit (MICU) to the NRCU are initiated by the MICU service and depend upon the patients acuity and available bed space in both units. The riurse-to-patient staffing ratio in the NRCU is typically one RN to three patients on the day shift, and one RN to four to five patients on the evening and night shifts. For comparison, the nurse-to-patient ratio in the MICU is one RN to one to two patients on all shifts.
Patient care in the NRCU is facilitated by extensive use of noninvasive monitoring equipment. Physiologic parameters monitored noninvasively include heart rate and rhythm, blood pressure, oxygen saturation, end-tidal C02 level, respiratory rate, patterns of breathing, respiratory mechanics, lung volumes, and peak flow.