NURSING
Divisions and Units
Patient centered care is important to us, and we are committed to health care at its most human and compassionate level. As a result, everyone who receives care is treated with respect and dignity. The following provides an extensive overview of how the nursing practice at SCVMC is arranged, and general information of our division and units.
Registered Nurses, Licensed Psychiatric Technicians (LPT), and Licensed Vocational Nurses (LVN) require at least one-year of acute care or emergency psychiatric care prior to being hired. Nursing Attendants (NA) require experience in the care of the seriously mentally ill patient. The psychiatric general nursing orientation consists of a three and half day program and 20-24 days of clinical inpatient and emergency orientation for Psychiatric Nurse I and IIs, 16 days for LPT/LVNs and 15 for NAs. An additional didactic course focusing on the care of seriously mentally ill patients, psychiatric medications and mental assessment exams are added if needed. A Clinical Partner is assigned to each employee.
The Psychiatric Staff Developer's primary role is the didactic psychiatric education, orientation competencies and assisting the Nurse Manager, Shift Supervisor and Assistant Nurse Manager in the unit competency process, and any remediation if necessary. The Staff Developer provides annual / bi-annual competencies and testing for all employees in both the annual mandated assault crisis training courses and at the unit level. The annual mandated course is updated annually to meet the needs and trends of the Department.
The Ambulatory Surgery Unit (ASU) is a multifaceted unit. A preoperative (preop) nurse assesses outpatients prior to the day of surgery. This is done at the APO clinic visit and again on the day of surgery. The ASU RN assures the patient meets health and nursing criteria prior to surgery.
The OR staff provide nursing care for elective, emergent, urgent and trauma procedures in ENT, Burn, Plastics, Eye, Dental, Podiatry, Cardiac, Neuro, GU, GYN, Orthopedic, Pediatric, Vascular and General Surgeries. Nursing coverage is provided through in-house and on-call staffing 24 hours a day, every day. Surgical procedures are scheduled by block scheduling, Monday through Friday. Every patient has an RN circulator. RNs can be assigned to the scrub role.
In the Post Anesthesia Unit, the nurse manages the immediate post-operative care of the surgical patient directly from the operating room. Inpatients and outpatients of all ages and levels of stability having undergone a surgical procedure and requiring Stage 1 recovery are cared for in the Post Anesthesia Unit. Inpatients are transferred to their respective unit from the Post Anesthesia Unit following primary recovery. Nursing coverage is provided through in-house and on-call staffing 24 hours a day, every day. Annual skill training is also provided to all nurses.
GENERAL PEDIATRICS & PEDIATRIC INTENSIVE CARE UNIT
General Pediatrics consists of a 12-bed Pediatric Intensive Care Unit (PICU) and a 33-bed acute Pediatric Unit (including Pediatric Rehabilitation beds). These units are state-of-the-art, with central monitoring throughout. SCVMC practices family centered care and patient rooms were designed with that in mind. There are sleeping accommodations for parents and they are encouraged to stay and participate in their child's care. A fully equipped playroom is available for patients, parents and families.
The pediatric team consists of nursing, social services, case management, a Child Life Specialist, as well as physical, occupational and speech therapies. SCVMC also has a dedicated pediatric Pharmacist. Medical staff consists of attending physicians and residents from Stanford/Lucile Packard Children's Hospital.
Our units consistently rank in the 75th percentile in the overall rating in HCAHPS hospital surveys, which measures patients’/families’ perspective on hospital care. We have a fast-paced environment where teamwork is paramount in the delivery of care to our patients and families. We are always looking for enthusiastic, self-motivated nurses dedicated to the well-being of children, who have excellent interpersonal and communication skills. Our staff celebrate Pediatric Nurses Week every October and participate in the Heroes Run every November. We take great pride in the care provided to patients from newborns up to 18 years of age. We also work collaboratively with other disciplines to deliver excellent care to our patients and their families. New nurse orientation is customized to meet the specific learning needs of each new hire. We are a teaching hospital and work closely with our pediatric residents from LPCH and Attendings. We are one of only two Bay Area facilities offering inpatient pediatric rehabilitation. We are also a level II pediatric trauma center.
NEONATAL INTENSIVE CARE UNIT
Providing the highest level of care, the Neonatal Intensive Care Unit (NICU) treats approximately 400 newborns and infants a year who are born at Santa Clara Valley Medical Center or transported in from surrounding community hospitals. Infants admitted to the 40 bed NICU are born premature or with life-threatening conditions. The hospital serves as the only Regional Center in San Jose specializing in high-risk maternal care, neonatology, pediatric surgery, and genetics. Antenatal and neonatal transport services, high frequency ventilation, inhaled nitric oxide, are among some of the state-of-the-art and innovative therapies. SCVMC NICU was the first center in Santa Clara County to develop a total body cooling program and has served over 81 babies since 2008. The NICU participates in numerous NIH funded research studies and provides resident training for Stanford University’s Medical School.
Neonatologists supervise the care of these infants 24 hours a day. A full complement of registered nurses, neonatal nurse practitioners, respiratory therapists, and support staff provide each infant with the care that is needed while hospitalized. After discharge, Nurse Practitioners from the BRIDGE Program provide home visits for the high risk patients in partnership with Public Health Nursing Care.
As the recipient of the prestigious Gage Award and honored twice with the Wirtschafter Quality Improvement Award, the NICU is recognized for their dedication to continuous quality improvement. This dedication to the highest quality of care is demonstrated by successful total body cooling outcomes, the best performance in human milk nutrition at discharge, the shortest duration of antibiotic use and the shortest length of stay in the state.
The NICU provides excellent clinical expertise in a family-centered and developmentally sensitive atmosphere including lactation specialists to support and encourage breast feeding. The NICU was chosen by the March of Dimes as the Northern California site for the NICU Family Support Program. This program provides family support coordinators who have had babies in the NICU and now support families through their NICU journey.
The Coronary Care Unit (CCU) is a fully equipped eight-bed unit with highly trained professional staff. The staff here treats patients with myocardial infarction, congestive heart failure, and cardiogenic shock, as well as pre-op open-heart surgery patients. The CCU staff is also trained to care for critical patients after coronary interventions such as PTCA, stent placement, and arthrectomy. The staff has advanced life support training and assist when in-house code blues are called.
BURN CENTER
Santa Clara Valley Medical Center’s Regional Burn Center is an eight bed intensive care and rehabilitation unit that cares for patients of all ages from pediatric to geriatric. The Burn Center is verified by the American Burn Association in adult and pediatric burns and serves seven surrounding counties. Care of our patients with burn injuries begins from the time of injury through reentry into the community. The Burn Center team is multidisciplinary, consisting of physicians, registered nurses, burn technicians, dieticians, medical social workers, case managers, psychologists, and occupational and physical therapists. The Burn Center nursing staff is specially trained in the delivery of burn care, wound management, pediatrics and critical care. The staff of the Burn Center is committed to providing excellent patient care, using evidenced based research. We also work extensively in the community to provide school re-entry, and outreach activities.
INTENSIVE CARE UNITS
Medical Intensive Care Unit (MICU)
The Medical Intensive Care Unit staff work in an eight-bed unit that manages patients with chronic medical conditions such as end-stage renal disease, GI bleeds, drug over doses, septic shock and respiratory failure. The MICU staff is rigorously trained. Registered nurses are certified in advanced cardiac life support to provide care for severely ill medical patients.
Surgical Intensive Care Unit (SICU)
The Surgical Intensive Care Unit is an eight-bed unit with a staff that provides care for patients who have undergone neurosurgical procedures, cardiovascular surgery, complex abdominal surgery, and thoracic surgery, or may have suffered an acute spinal cord or head injury.
Trauma Intensive Care Unit (TICU)
The Trauma Intensive Care Unit is an eight-bed unit that provides care for patients who have undergone neurosurgical procedures, cardiovascular surgery, complex abdominal surgery, and thoracic surgery, or may have suffered an acute spinal cord or head injury.
The Emergency Department (ED) is an integral component of the SCVMC Trauma Center. The unit consists of 24 beds, all with monitoring capabilities. The ED is recognized as the only comprehensive Emergency Department in Santa Clara County and the houses the county's only Paramedic Base Station, giving our nurses the opportunity to become Mobile Intensive Care Nurse (MICN) certified. The ED staff treat and care for a diverse population of approximately 70,000 patients per year. ED nursing staff interact with nearly every specialty in the medical center. Patient conditions range from minor illnesses to life-threatening diseases and injuries. The Sexual Assault Response Team (SART) is another important part of this dynamic department. The multidisciplinary, team-oriented work environment that presents opportunities that may rarely be experienced in other Bay Area hospitals. Our ED will be undergoing anexpansion in the next several years that will increase our capacity to 54 beds, with 4 dedicated adult and pediatric trauma beds.
MATERNAL CHILD HEALTH DIVISION
The Maternal Child Health Division is devoted to the care of women and children. Santa Clara Valley Medical Center practices family-centered care, and the hospital is designed with that in mind. A comprehensive range of services is offered, and an exceptional continuum of care is provided to mothers and their children. Whether a patient is in the Neonatal Intensive Care Unit, has been seen at the High-Risk Maternity Program, or needs the services provided by the Pediatric Intensive Care Unit, the registered nurse is always an integral part of the team providing outstanding care.
The Maternal Child Health Division consists of five separate units (see below) with 152 beds. The division units support one another in an environment of healing.
LABOR AND DELIVERY (L&D) UNIT
The Labor and Delivery Unit delivers between 450 and 550 babies a month, making it one of the busiest L&Ds in the state. L&D has 14 labor, delivery and recovery rooms as well as a four-bed triage area to evaluate patients in early labor. L&D staffing for each shift consist of 12 to 13 RNs, 1 OBT, 2 to 3 USA (clean rooms, transport patients and equipment) and 1-2 clerks. Each shift has an Assistant Nurse Manager. The unit also has a Nurse Coordinator and a storekeeper. This staffing level allows each nurse to care for 1-2 patients, following AWHONN/ACOG guidelines. All RN staff have ACLS and NRP certification.
Mothers labor, deliver, and recover in the same room. Newborns remain with their mother during the recovery, but most of the assessments and administration of medication is done by the Mother-Infant Care Center staff. SCVMC has a cesarean section rate of 18-19%. L&D staff scrub, circulate and recover these patients. SCVMC has a renowned Level III Neonatal Intensive Care Unit (NICU). NICU staff attends all high-risk deliveries.
MOTHER INFANT CARE CENTER (MICC)
After giving birth the mother and her infant will be transported to the Mother Infant Care Center where they are cared for together in the "couplet model" of mother-baby care. The MICC currently has 56 beds. The focus here is on family centered mother-baby care for patients of all levels of acuity. The MICC nurses provide care for stable ante partum patients, as well as postpartum mothers and newborns.
The staff of the MICC is culturally diverse, as is the hospital's patient population. The turn over of staff on this unit is very low. The MICC nurse typically cares for 3 to 4 couplets and provides primary care services. The MICC has two IBCLC lactation consultants who provide breast-feeding instructions and support for patients who want to breastfeed their babies. The MICC also has a full time Staff Developer who facilitates educational planning and other programs for the staff. The medical staff consists of attending OB physicians and OB residents from the hospital's OB Residency Program, as well as attending pediatric physicians and Stanford pediatric residents. Pediatric nurse practitioners provide support for the MICC and are involved in the infants' discharge exams.
With 4 separate nursing units covering a total of 216 licensed beds the Medical Surgical specialty at SCVMC provides medical and post-operative care for a variety of patients requiring comprehensive care and procedures. Essential to the care of these complex patients is an interdisciplinary team skilled in the areas of post-operative disease processes and medical management. Santa Clara Valley Medical Center provides care for patients with the following conditions and much more:
- Disorders of the pulmonary system, gastrointestinal system, renal system, endocrine system, circulatory system, neurological system, as well as infectious diseases, dermatological disorders and autoimmune disorders
- Oncology
- Palliative Care
- Trauma
Specialty Surgical services including orthopedics, gynecology, plastics, urologic and many others. - Plastic Surgery
- Emergency General Surgery
SCVMC provides patient centered care in a collaborative environment that enables patients and their loved ones to cope with the illness or injury. We believe that exceptional care is delivered compassionately with an emphasis on cultural sensitive teaching and communication to help patients achieve maximum quality of life.
The Operating Room (OR) Services Team is committed toward meeting the needs and providing the necessary care of each individual patient undergoing an invasive surgical procedure. Perioperative services include elective, emergent, urgent and trauma procedures for all surgical services in the operating room. Nursing coverage is provided through in-house and on-call staffing 24 hours a day, every day, in both the OR and Post Anesthesia Unit. Conferencing Education is provided weekly in OR.
Santa Clara Valley Medical Center Rehabilitation has a long history of leading-edge rehabilitation care. We helped pioneer the interdisciplinary team model that has become a national standard for rehabilitation programs. Our innovative research efforts continue to bring new technology, therapies and protocols to our patients. Backed by these resources, our care team brings together a diverse range of skills and experience for the single purpose of helping to rebuild lives following serious and often catastrophic injury and illness.
As a basic part of that goal, we believe that the uniqueness of each patient is best served by an equally unique approach to care. This belief is built into the highly personalized care plans that help direct the rehabilitation of each patient. It’s also part of an approach in which the team of physiatrists, other physician specialists, nurses, therapists, psychologists, social workers, and case managers provide consistency during the rehabilitation along with the flexibility to quickly change personnel and resources as the patient’s needs change within the recovery process.
On the most basic level, the highly individualized focus on each patient means that we’re not just treating brain injury, spinal cord injury or stroke; we are caring for the specific person and family affected by the condition.
ACUTE REHABILITATION NURSING
The 76-bed Rehabilitation Center at Santa Clara Valley Medical Center is a highly specialized unit within this acute care hospital. The Rehabilitation Center is made up of three separate and mutually supporting units devoted to the care of catastrophic injury patients. Rehabilitation nursing at SCVMC provides an opportunity to participate in the whole spectrum of rehabilitation nursing including spinal cord injury, brain injury, respiratory injury, stroke, burn and general rehabilitation.
BRAIN INJURY UNIT
The Brain Injury Unit is a 32-bed unit with patients who may have sustained brain injuries, strokes or other neuromuscular disorders as well as medical-surgical conditions requiring rehabilitation. Nurses on the Brain Injury Unit work in a challenging and rewarding environment that requires strong interpersonal communication skills, organizational skills, and an emphasis in teamwork. Nurses work closely with the interdisciplinary team to help the patient reach their individualized goals and discharge back to the community. A professional nurse on this unit has a crucial role in providing compassionate comprehensive care, as well as essential caregiver education the patient will require upon discharge.
RESPIRATORY REHABILITATION UNIT
The Respiratory Rehabilitation Unit is a 10-bed acute pulmonary care unit for patients with acute spinal cord and/or brain injuries. Many of these patients come to this unit within hours after their injury. This unit is very innovative and the only one of its kind in the Western US.
SPINAL CORD INJURY UNIT
The Spinal Cord Injury Unit is a 22-bed unit providing comprehensive support for the emotional and physical needs of patients with acute spinal cord injuries. The unit also includes a four-bed ventilator-dependent quadriplegic unit (VDQ), one of the very few in the United States. These patients include a high percentage of young, motivated people who expect to return to their communities as independent as possible. The staff here works to help rebuild family dynamics during the first critical months following an injury.
Each year, an average of 150-200 people receive inpatient rehab for SCI in our specialized 22-bed unit that is particularly well-equipped and staffed to care for patients with acute spinal cord injuries, including high-quadriplegic patients. Physiatrists head up the interdisciplinary care teams that include the most SCI-boarded physicians of any rehab center on the West Coast. Our patient satisfaction, discharge-to-community and functional independence outcomes have been awarded for exceeding the national averages for individuals receiving are and treatment. While these patient outcomes reflect the skills and experience of our staff, they also speak to the accomplishments of the people we serve in their journey toward the highest possible levels of productivity, independence and quality of life.
The Progressive Care Unit (PCU) is a 36-bed step down and telemetry unit for patients requiring cardiac monitoring and observation. It also provides care for adult neurosurgical, neurological and trauma patients who present with an acute neuro disease process.
In the PCU, specialized nursing care is provided to potentially unstable patients requiring frequent observations and /or intervention. Specialized care is also provided to patients requiring cardiac monitoring such as S/P coronary interventions e.g. PTCA and pace maker insertion. Other PCU patients include those with potentially lethal arrhythmias requiring elective cardioversion, R/O MI, and S/P cardiovascular surgery.
The registered nurses are ACLS certified and are trained to care for patients on ventilators and/or with acute pulmonary disorders. They are also trained to care for patients needing peritoneal dialysis and chronic renal failure. The nurses work closely with the physicians, Physical, Occupational, and Speech and Respiratory therapists.
Valley Medical Center and Clinics, your first choice for primary care where patients are family. Primary care nursing requires a variety of skills and expertise in the following areas: treatments and procedures, health education, care coordination, prevention and health maintenance and population health management. VMC encourages RNs to demonstrate their professional and compassionate ability to provide health care in a patient centered medical home throughout a patient’s lifetime encompassing pediatrics, obstetrics and gynecology, internal medicine, geriatrics and behavioral health. We offer these services and career opportunities in a variety of settings: multidisciplinary clinics, mobile units, homeless shelters, and local traveling teams serving the patient where they or the need may be located. The primary care RN must be adept at communications, organizational skills, leadership, teamwork, prepared for the unexpected, treat the acute and chronic conditions of the diverse patients we serve in the metropolitan, suburban, rural and remaining agricultural areas of Silicon Valley within Santa Clara County.