Progressive Care Unit Overview

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Introduction   

When hearing the phrase progressive care unit, what comes to mind? Whether you’re new to nursing or have been a nurse for many years, at some point in your career, you’ve heard of a progressive care unit (PCU). Maybe you are currently working on that unit or are interested in working there in the future. As health care and nursing continue to evolve in America and around the world, so does the nurse’s role in patient care. Several PCUs hire registered nurses (RNs) from all specialties and educational backgrounds. Patients and healthcare systems will always need someone to help with patient care, especially in determining the severity of a patient’s health condition.  

The information in this course will serve as a valuable resource for nurses interested in learning more about working in the PCU and the scope of care involved in PCU nursing.  

Defining the Progressive Care Unit (PCU) 

Oftentimes among nurses, critical care nursing is viewed as some of the most challenging care for patients, as patients receiving critical care interventions are one step away from severe health complications or immediate death. The intensive care unit (ICU) is often reserved for the most critical of patients, such as those who have severe infections, are recovering from devasting motor vehicle accidents (MVAs), or other extensive physical trauma that requires several medical interventions. Interventions in the ICU often include several intravenous (IV) medications, fluids, assisted respiratory devices, catheters, and more. Nurses in the ICU often care for one to two patients at most, given the complex, critical care requirements for the patient and staffing at the hospital. Several ICU patients are unable to move, speak, or function without severe immediate assistance from healthcare workers.  

In contrast, nurses in medical-surgical (also known as med-surg) units often care for patients who are recovering from surgeries, such as gallbladder removal surgery or knee replacement surgery. Most med-surg patients need to be monitored before hospital discharge or other medical interventions are deemed appropriate, but they do not require the same level of care as an ICU patient. (1,2,3) 

This is where progressive care units (PCU) emerge, as they are units in health care facilities that step in between ICU and med-surg level care. PCUs are also called step-down units in several hospitals because PCUs are the bridge between ICU and med-surg care. Nurses working in the PCU or step-down unit typically focus on a few patients at a time to ensure that the patient is no longer considered critical, but stable enough to be progressing in their health.  

Patients in the PCU are more likely to speak on their own, use the bathroom on their own, and move a little bit, but they are still not cleared for a regular med-surg unit. PCU patients might have more difficulty eating or might need extra monitoring because of their medical history. 

Nurses in the PCU have an essential role in providing care and assisting in determining the stability and critical care nature of patients in the step-down unit. (1,2,3,4) 

What Is Nursing Care Like in the Progressive Care Unit? 

Nursing in the PCU or step-down units is often a place of several discussions among nurses, other health care workers, and health care administration. Oftentimes, many nurses in the PCU are RNs or licensed practical nurses (LPNs) in some states who are interested in providing patient care to those in this unit. PCU nurses exist in all 50 states with no sign of slowing down. Some PCUs are specialized, such as cardiac PCU, pediatric PCU, respiratory PCU, and gastrointestinal PCU care.  

Other times, depending on the type of healthcare facility, a facility might have a general PCU ward. For instance, a major hospital in a major city might have several designated PCUs, whereas a hospital in rural America might have one PCU. Some PCUs assign a few patients to a nurse, whereas other PCUs might assign only one patient to one nurse. Because of several factors influencing patient care, such as mandated nursing-to-patient staff ratios, patient care needs, staffing availability, healthcare facility protocol, state and national nursing regulations, and more, the exact patient load and care provided by nurses to PCU patients can vary widely (1,2,3,4). 

That said, nursing care is nursing care, regardless of where it is performed. Nursing care in the PCU often consists of similar nursing duties seen in a med-surg unit, such as vital sign monitoring, patient assessment, medication administration, collaboration with other healthcare workers, and other similar tasks. PCU nursing often involves more patient monitoring, such as increased vital signs monitoring, more focused patient assessment (such as more frequent neurological checks or urinary output checks), and more awareness of the patient’s condition. 

Often, patients are brought to the PCU for additional monitoring because of possible, suspected surgical complications, complex medical histories, the need for extra beds in the ICU, or a result of a shortage of beds in the med-surg unit. PCUs can also be found in specialist hospitals as well, such as mental health hospitals, pediatric hospitals, and more. At its core, PCU nursing involves critical thinking skills, patience, and communication when working with families, patients, and healthcare professionals (1,2,3,4).  

What Are the Differences Between the Intensive Care Unit, Progressive Care Unit, and General Units? 

ICUs, PCUs, and general units make up the bulk of several inpatient care units in thousands of healthcare facilities in America and around the world. As stated above, the intensive care unit (ICU) is often reserved for the most critical of patients, such as those who have severe infections, are recovering from life-altering VMAs, or other extensive physical trauma that requires several medical interventions. Many times, ICU nurses often have a few years of experience in other nursing care, such as working in a med-surg unit or emergency room, before working in the ICU given the severe patient acuity and medical interventions involved.  

Many newly graduated nurses work in ICUs, and certifications can be obtained for critical care nursing. ICU nursing is often very physically demanding, requires a high degree of understanding of several concurrent medical interventions, and demands excellent communication skills between health care providers and the patient’s caregivers. Oftentimes, ICU patients are unable to speak, so providing real-time, evidence-based updates to a patient’s caregiver(s) is often essential and truly life-changing for many patients who survive ICU care. ICU nursing often consists of 12-hour shifts in a hospital caring for one or two patients max per shift, and several ICUs are broken down by specialties, such as the cardiac ICU, neurological care ICU, and general ICU, depending on the health care facility itself (1,2,3,4). 

Compared to the ICU, PCUs have emerged as a result of the care gap between ICU and med-surg level care. As stated above, PCUs are also called step-down units in several hospitals because PCU is the bridge between ICU and med-surg care. Given the rise of medical interventions that can be monitored and managed outside of the ICU or to adjust the flow of patient care depending on hospital needs, PCUs serve as a good intermediate between general unit care and ICU care. 

Oftentimes, nurses working in the PCU have a few years of experience in other areas of nursing, but many PCUs hire and train newly graduated nurses as well. Given the flow of patient care, nurses working in the PCU or step-down unit typically focus on managing a few patients at a time who are stable but not critical. A stable patient often refers to a patient with stable vital signs, who does not need continuous monitoring, or who is recovering from a medical intervention appropriately. A critical patient is a patient who has critical healthcare needs and often needs several healthcare workers to provide care to that patient. With the rise of advances in health care, the role of the PCU and PCU nurses has been a topic of much discussion.  

Historically, PCU patients need additional monitoring than what is expected of in a general recovery unit, but their needs are not as critically intensive as an ICU patient. Yet, there is no set clinical guideline for what constitutes a PCU or ICU patient placement. Oftentimes, the difference between PCU and ICU care depends on staffing, the facility itself, regulations, patient status, and judgment of healthcare workers, including nurses (1,2,3,4). 

Knowing the roles of the ICU and PCU, general inpatient units in the hospital are often the med-surg units, the labor and delivery units, or general observation units. The emergency room, while an entry point for many patients seeking care, is typically an outpatient setting, resulting in many discharges throughout a 24-48 period (unless there is a severe emergency within the hospital or community itself).  

Units for inpatient care other than the PCU or ICU often have patients with various health concerns being seen and cared for by nurses of various specialties. For instance, the postpartum unit in a hospital could be considered a general observation unit, akin to a medical-surgical unit for new mothers and their babies. Some hospitals also have high-risk pregnancy observation units, high-risk oncology units, and other units to monitor and care for patients as needed. Typically, nurses can work in the labor and delivery, emergency room, or oncology units within the scope of their careers. Oftentimes, some units require more education and further training to properly care for patients in these situations; however, nurses can often work in these units as new graduates as well. In general, depending on the type of facility and facility protocols, there are float nurses who work between the ICU, PCU, and general units for a few shifts, which is also an option for nurses who want a variety in patient care or who are working per diem (1,2,3,4).  

How and Where Are Nurses Working in the Progressive Care Unit? 

Nurses are working in PCUs in all 50 states in America. If a healthcare facility has a PCU, they have nurses working in that PCU as long as that PCU has patients. From rural America to inner city health care systems, PCUs are here to stay. The exact scope of work for nurses in the PCU can vary depending on state and local regulations, rules, and workplace guidelines.  

In general, PCU nurses work to the full extent of their nursing license, similar to other nurses. Because there are no set clinical guidelines for the full scope of work for nurses in PCU care or critical care, it is important to verify with your place of work and nursing boards if you have questions. Most nurses working in PCUs presently are RNs, but some PCUs hire LPNs as well. In general, more hospitals hire RNs instead of LPNs because of the more advanced scope of work and education associated with RNs compared to LPNs. Most RNs have completed an Associate or Bachelor in Nursing.  

If you are interested in learning more about working in a PCU, it is recommended to shadow a unit before working there to see if it is something you would be comfortable with. Consider doing your research into PCU nursing before deciding to work in this unit (1,2,3,4). 

What Sort of Patient Population Is in the Progressive Care Unit? 

PCUs can vary widely in their patient populations. Some PCUs have dedicated units for pediatric cardiac or neurological care, whereas some PCUs see patients of all ages. Several hospitals tend to have designated PCUs, such as cardiac step-down units or renal ICUs. Patients in the PCU, regardless of age, are typically inpatient for a variety of reasons, such as requiring ongoing monitoring of care after surgery, after ICU stay, or another similar situation (1,2,3,4). 

Progressive Care Unit Landscape 

The role of the PCU is ever evolving and constantly involves the critical thinking and critical care skills of nurses. While all aspects of nursing require critical thinking and skills, nurses often play a major role in whether a patient in the PCU stays in the PCU, is transferred to the ICU, is transferred to a general unit, or can be discharged from the hospital. While nurses do not have the final say in the placement of a patient, PCUs acting as intermediate locations for patient care require nurses to be extra vigilant of sudden changes in a patient’s health. Because PCUs can vary so widely among patient populations, patient care needs, and patient risk factors for further intensive care, excellent assessment and nursing judgment are essential for the PCU landscape (1,2,3,4,6). 

Scope of Work and Responsibilities Associated with PCU Care 

Nursing care is nursing care, regardless of where it is performed. As stated above, nursing care in the PCU often consists of similar nursing duties seen in a med-surg unit, such as vital signs monitoring, patient assessment, medication administration, collaboration with other healthcare workers, and other similar tasks. However, given the nature of PCU nursing, PCU nursing often involves more focused patient assessments, such as a more focused neurological assessment, cardiac assessment, or respiratory assessment.  

For instance, if you are working in a cardiac PCU, you are more likely to have to monitor patients for various cardiac rhythm changes compared to if you were on the cardiac med-surg unit. By working in the cardiac PCU, you would need to be more familiar with electrocardiogram (ECG) readings, use a more advanced stethoscope, collaborate with the telemetry unit more frequently, or perform more patient education on cardiovascular health.  

On the other hand, if you are working in a pediatric neurological PCU, you would need to be aware of performing neurological assessments in pediatric patients, become more familiar with sudden shifts in vital signs in pediatric patients, collaborate with neurology specialists more frequently, and educate the parents or caregivers as much as you can in addition to the patient (depending on the patient’s age). In particular, having a sharp sense of assessing a patient’s acuity, response to medical interventions, and health progression is essential to PCU nursing (1,2,3,4). 

While some general tools can be used to assess patient acuity for assignments in a PCU, nursing judgment and existing assessment tools and skills are the main drivers for assessing patient care and the next steps in the PCU. Because of the varied PCU needs, a nurse in the PCU might be performing a more thorough respiratory exam in one patient’s room compared to another patient who has more complex gastrointestinal exam needs. Since some PCUs are mixed with patients of various acuities, the nurse’s ability to detect changes is essential (1,2,3,4).  

In addition to salary, with the rise of telemedicine, remote patient monitoring, and other aspects of virtual nursing care, PCU nursing is expected to increase in demand in more remote parts of America. Even several hospital and health care systems are now relying on technology within and outside of organizations to monitor patient health (1,2,3,4,5,6) 

Common Medical Interventions and Situations for PCU Patients 

Typical medical interventions and situations for PCU patients are often similar to interventions and situations for patients in med-surg units. Establishing patent IV access, ensuring patients are breathing, ensuring patients are mobile to the best of their ability, monitoring a patient’s pain levels, and administering medications are common medical interventions for PCU patients. For instance, a patient might have experienced coronary artery bypass surgery a few days ago and is placed in the PCU. Before a patient can be transferred to the cardiac med-surg unit, the patient needs to be regularly monitored for sudden shifts in fluids (such as increased monitoring of urinary output and fluid intake), assessed for any adverse reactions from medications, and monitored for any changes in cardiac rhythms.  

Another situation for a PCU patient is performing care on a patient who survived a severe MVA a few weeks ago and is starting to eat on their own and move slowly on their own. After being transferred to the PCU from the ICU, this patient needs to be closely monitored for skin breakdown as a result of prolonged immobility in the ICU, electrolyte imbalances as a result of prolonged lack of eating, and changes in bodily functions as a result of the severe MVA. While both patients are in the PCU and under the care of the PCU nurse assigned to them, these two patients have very different entries into the PCU, vastly different healthcare histories, and similar yet distinct monitoring (1,2,3,4,5,6). 

The truth is, while some patients remain in the PCU for a few days, some patients can be in the PCU for several weeks, depending on the patient’s condition, facility size, staffing, and more. As a result, PCU nursing is often the mix between ICU and general units, leading nurses in this unit to do a bit of everything and to be extra vigilant of patients’ needs.  

A patient who experienced a sudden fall last week who had hip replacement surgery and is being transferred to the PCU is not going to have the same care needs as a patient who had severe COVID-19 complications and was placed in the ICU for a few weeks and is now more stable for the PCU. Because of the varied needs of patients, even as PCU nurses do their best, oftentimes, PCUs can be places where patients report high levels of dissatisfaction with care and where patient deterioration can be problematic. Because of the lack of clear guidelines on step-down care, the lack of sufficient staffing, the lack of protocols in place, the lack of consistency in documentation, and more similar concerns, worsening patient health is a significant concern for hundreds of PCUs.  

While PCU nurses do their best to provide patient care, inconsistencies in practice and lack of clear communication within healthcare teams can lead to severely negative patient outcomes, nursing burnout, and other health and healthcare complications (4,6,7,8). 

The Nurses’ Role in Assessing and Managing Patients in the PCU 

While I provided some examples regarding the nurses’ role in assessing and managing patients in the PCU, oftentimes, it is an extremely variable jack-of-all-trades nursing workplace. Some PCUs assign one nurse to one to two patients, whereas other PCUs assign one nurse to up to eight patients. Some PCUs see patients of all ages, whereas others only see pediatric or adult patients.  

A common notion about step-down care is that it is the place where all sorts of nursing can occur since it is so variable for patient care management and outcomes. A nurse working in the PCU might be assigned to three patients in a shift, and all three patients might be transferred to the med-surg unit at the end of that shift. On the other hand, that same nurse could recommend one patient be moved back to ICU care, one patient be discharged, and another remain in the PCU for further observation.  

The role of nurses in the PCU is to maintain patient health and monitor for deterioration and changes. Healthcare settings, including the PCU and other inpatient settings, can overlook skin breakdown changes, mood changes, adverse events of medications, and surgical complications. Many PCU patients can speak and perform basic activities of daily living (ADLs), and a patient’s input is often a great insight into assessing and managing a patient.  

Rarely is a patient in the PCU if they are unable to speak on their own, so listening to patient’s concerns and ensuring detailed assessments are completed and documented are essential for patient care. While health care is a field of several alarms, drips, and lines, making sure everything is accurate, and functioning is essential. Discussing concerns about a patient with the provider, respiratory therapist, occupational therapist, speech therapist, social worker, and other health care professionals is essential for the continuity of this patient’s care. PCU patients often have a care team assigned to them to discuss the pressing and concerning health needs and changes (1,2,3,4,6). 

Progressive Care Unit Dynamics and Healthcare Shifts 

While the PCU and other critical care units are very popular places for nurses to work, in terms of workplace dynamics, unfortunately, burnout is a common concern for many nurses. In particular, PCU nurses are often at the pull of various administrative aspects in their workplace, causing severe shifts in staffing, funding, patient loads, equipment, electronic health records (EHRs), and more. As a result, while many nurses have found enjoyment and fulfillment in their work, especially in the PCU and critical care settings, burnout is among the leading causes for nurses leaving the workforce and profession entirely.  

A leading cause of burnout among critical care nurses is the workplace environment. Many nurses often report not being able to practice to the full extent of their scope of work and having to deal with administrative concerns on the job. Several PCU nurses are concerned about unsafe staffing ratios, inconsistencies in patient care, and safety on the job. Patients also report several implications of the emotional and psychological toll of a prolonged inpatient stay, especially with transfers through various units (making the PCU a prime spot for emotional assessments that are often not performed). While evidence-based research has continuously shown that patients receive higher quality care when there is more adequate staffing, communication with various healthcare team members, and involvement of the patient and their caregivers, unfortunately, that is often not the reality for many patients in the PCU (6,7,8,9,10). 

If you are considering working in the PCU, it is recommended to take your time to assess the workplace environment and administration before working there. A PCU in one hospital might not be the same as a PCU in another hospital because of the various natures of PCU care. While PCUs exist in several hospitals, the varied patient population, clinical presentations, and workplace dynamics can all affect your work performance and patient care outcomes. 

Many people choose to become nurses for their love of patient care. However, many things can affect your overall quality of life as a nurse and your ability to practice as a nurse, such as the types of schedules you would work, the income and benefits, the number of patients you are expected to care for, and the workplace dynamics. Negotiating and discussing your needs before accepting a position is essential to prevent burnout and to ensure a long career as a nurse in the PCU (6,7,8,9,10).  

Role of Critical Care Nursing and Technological Advances 

As everyone has their own opinion on technology, technology is here to stay, especially in health care and especially for nurses involved in critical care. For many nurses in the PCU, nurses use EHRs, machines to monitor blood pressure and glucose levels, and more to assess and manage patient care. As technology continues to advance, so does the role of artificial intelligence (AI). 

While there are many discussions about the implications of AI in nursing, several healthcare agencies are expanding the use of AI, remote patient monitoring, and remote technological advances to reduce barriers to care quality, streamline healthcare efficiency, and maximize patient outcomes. While there are also several concerns about nurses and the role of AI and the quality of care a patient could receive with AI, if you are a nurse working in the PCU or considering working in the PCU, you need to be aware of the emerging nature of AI in your workplace (5,11). 

Nursing Considerations 

What is the nurses’ role in progressive care unit patient management? 

Nurses remain the most trusted profession for a reason, and nurses are often pillars of patient care in several healthcare settings. Patients turn to nurses for guidance, education, and support. While the scope of work of nurses in the PCU can vary state by state and by various workplaces, here are some general insights into the role of PCU in patient care (1,2,3,4,5,6,11). 

1. Take a detailed health history. Oftentimes, if a patient is in the PCU, they either had a severe trauma before surgery or something that led them to this unit. Most patients in the PCU can communicate, so, if possible, review and confirm the patient’s health history. Take your time to review their surgical notes, trauma notes, inpatient stay records, vital signs over time, and more.  
   • Noticing patterns and histories is essential to prevent worsening patients’ health. If a patient is complaining of symptoms, inquire more about that complaint. Ask about how long the symptoms have lasted, what treatments have been tried, if these symptoms interfere with their quality of life, and if anything alleviates any of these symptoms. If you feel like a patient’s complaint is not being taken seriously by other healthcare professionals, advocate for that patient to the best of your abilities. Take the time to establish care with that patient.  
2. Review medication history at every encounter. Oftentimes, in busy hospital inpatient settings, reviewing health records can be overwhelming. While millions of people take medications, many people take medications and are no longer benefiting from the medication. Ask patients how they are feeling on the medication if their symptoms are improving, and if there are any changes to medication history. Make sure to specify if the patient is taking any over-the-counter supplements or herbs as well. When you receive orders for medications, make sure they are consistent with what was either discussed earlier or with what was prescribed earlier for consistency and reduction in medical administration errors.  
3. Ask about family or surgical history, especially in post-surgical settings. Several studies have indicated family history can play a role in the likelihood of a person developing a health condition. Surgeries can also trigger complications from other surgeries, so that is important to ask as well. If someone is complaining of symptoms that could be related to a more serious health condition, ask if anyone in their immediate family, such as their parent or sibling, experienced similar conditions. 
4. Be willing to be honest with yourself about your comfort level discussing topics and providing education on medication and health conditions. If you are not comfortable discussing something, please refer to another staff member. 
5. Communicate the care plan to other staff involved for continuity of care. For several patients, if they are in the PCU, their health care often involves a team of health professionals, nurses, therapists, specialists, pharmacies, and more. Ensure that patients’ records are up to date for ease in record sharing and continuity of care. 
6. Stay up to date on continuing education related to PCU and critical care nursing, as evidence-based information is always evolving and changing. You can then present your new learnings and findings to other healthcare professionals and educate your patients with the latest information.  

How can nurses identify if they are interested in working in a progressive care unit? 

Truly, a career in nursing is rewarding personally, professionally, financially, and emotionally. Nurses are among the largest healthcare professionals in the United States, and several nurses report high levels of satisfaction with their work. The truth is, while nursing is a highly respected and rewarding career, nursing care can vary widely. A nurse in the PCU is not going to have the same workload or patient population as a nurse working in a retirement home or a nurse working at an immunization clinic at the public health department.  

The reality of PCU nursing is the reality of being able to handle the jack of all trades in nursing care. From blood transfusions to focused neurological assessments and remote patient monitoring, PCU nurses do a little bit of everything. While that can be very rewarding and enjoyable for some nurses, the PCU lifestyle and work are not for every nurse.  

If a nurse is interested in working in a PCU, they should consider why they want to work in a step-down unit and what they love about nursing. A nurse should also consider how comfortable they are with the unpredictable nature of PCU patients, the responsibility associated with transferring patients to various units, and the experience of working with different groups of people.  

If you think you are interested in a career in the PCU, doing your own research and assessing the job market are great starting points to see if this is a career path for you.  

What should patients know about being in the progressive care unit?  

Nurses should also teach patients to advocate for their own health to avoid untreated or undetected side effects of medications or other medical interventions. Here are important tips for patient education in the inpatient or outpatient setting.  

• Tell the health care provider of any existing medical conditions or concerns (need to identify risk factors) 
• Tell the health care provider of any existing lifestyle concerns, such as alcohol use, other drug use, sleeping habits, and diet, (need to identify lifestyle factors that can influence PCU care, medication use, and management) 
• Tell the nurse or health care provider if you experience any pain that increasingly becomes more severe 
• Tell the health care provider right away if you are having thoughts of hurting yourself or others (possible increased risk of suicidality) 
• Tell the health care provider or nurse if you notice any changes while taking medications or on other treatments to manage your health (potential worsening or improving health situation)  
• Tell the nurse if you have any allergies, skin concerns, or issues you would like to address with them (possible increased risk of skin breakdown, allergic reaction from prior medical interventions, and patient self-advocacy) 

Upcoming Research 

What Research on Progressive Care Unit Nursing Exists Presently? 

There is extensive publicly available literature on progressive care unit nursing and critical care nursing via evidence-based journals and nursing research. 

Case Study #1 

Beth is a nurse working in the cardiac PCU at a major local hospital. She has worked in neurologic med-surg for four years and enjoys her work in the PCU. For her shift today, Beth is assigned to care for three patients, one of which is scheduled to be transferred to the cardiac med-surg unit later in the afternoon. Beth performs her assessments on her patients.  

Her patients today are: 

Room 1 – a patient with heart failure-induced cardiac shock recovery patient transferred from the cardiac ICU two days ago, Room 2 – a patient with coronary artery bypass surgery recovery from surgery a few hours ago, Room 3 – a patient who received an angioplasty last night in the emergency room. The patient in Room 3 is scheduled to be transferred to the cardiac med-surg since last night, the cardiac med-surg did not have beds available. Beth begins to perform her morning assessments on these patients.  

Case Study #1 Continued 

Beth has completed her morning assessments, given medications, and is reviewing her patient’s records. Beth notices that all of her patients have been doing well, and they are not reporting any extreme pain or discomfort. Her patient in Room 1 is more mobile now in the PCU compared to the ICU and is drinking water slowly. Her patient in Room 2 is resting after surgery with no visible surgical complications, fluid complications, or hemodynamic instabilities. The patient in Room 3 is scheduled for transfer to the cardiac med-surg unit, and Beth wants to confirm some things with the patient before the transfer. When Beth goes to Room 3 to discuss the transfer with the patient, she notices that the patient is holding their chest a bit tightly and is reporting some more pain in the chest area. The patient also states that they went to drink water earlier, they felt some pain in their throat. You see that the patient’s transfer is in a few hours, so you decide to assess the patient before transfer.  

Case Study #1 Continued 

Beth assesses the patient in room 3 and notices that their BP is 190/100, temperature 100F, HR 110bpm, and respirations 16 per minute. The patient appears stable, as they are talking to you and discussing moving to the other unit. You look over the patient’s chart and notice that they are not on any anti-hypertensive medications and have no history of hypertension. The patient reports chest tightness that is not going away.  

Conclusion

Nursing and PCUs are here to stay, regardless of their role in AI. While there are some technological advances along the way, in general, nurses and nursing judgment remain critical for PCU care.  

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