Nursing Practice Areas

Nurses on this fast-paced 28-bed medical surgical telemetry unit care for patients with most phases of cardiac disease. Staff emphasize rehabilitation, education and lifestyle changes or modification for patients. The patient population includes those post-MI, post-open heart surgery, post-thoracotomy, pace-makers, pre-and post-angiography, post-cardiothoracic surgery and pulmonary patients, and those who have suffered congestive heart failure or COPD.

The Cardiac Catheterization Lab performs coronary angiography, percutaneous coronary interventions, electrophysiology studies, structural heart disease interventions, radiofrequency ablations, and pacemaker and defibrillator insertions. Staff collaborate with Cardiotesting, Pre Op, Exercise Physiology departments and the Cardiothoracic Surgery teams. The Cardiac Catheterization Lab contains two interventional suites, one electrophysiology suite and utilizes the hybrid operating room suite.

With a long-standing reputation for premier diagnostic and therapeutic capabilities, we treat many complex and high-risk cardiac conditions. The Heart Institute's multispecialty team includes specialists in cardiology, cardiothoracic surgery, congestive/chronic heart failure, pediatric cardiology and electrophysiology.

A nursing team is assigned to each cardiologist or surgeon and coordinates care for the patients. Nurses assess the patient's overall health and educate about medical conditions, medications, tests/procedures and the plan of care. The nursing staff has extensive experience in medical and surgical cardiac care, as this outpatient clinic serves more than 1,000 patients per month.

The Critical Care unit is a fast-paced, 20-bed unit that provides a broad range of medical and surgical specialty services. The Critical Care unit's multidisciplinary team consists of highly skilled RNs, Critical Care technicians, advanced practice nurses, intensivists, pharmacists, a respiratory therapist, health unit coordinators and other support staff.

This unit provides patient- and family-centered care for a variety of high-acuity patients including post-cardiothoracic surgery, neurovascular interventions, ventilated patients, continuous renal replacement therapy and post-cardiac arrest care.

Nurses in our Level II ACS-verified Trauma Center provide care to over 60,000 patients annually with a wide variety of physical and emotional needs. The department consists of 40 patient exam rooms, five resuscitation/trauma rooms, eight Urgent Care rooms and three dedicated Behavioral Health rooms. Nurses are part of a multidisciplinary team that includes emergency physicians, EMTs, paramedics, health unit coordinators and social workers. Patients have 24-hour access to laboratory, X-ray and surgical services. We are also a Stroke Center with 24/7 neuro-interventional capabilities and a Chest Pain Center with 24/7 interventional cardiac catheterization lab capabilities.

Patient volume and statistics

• More than 60,000 combined Emergency and Urgent Care visits
• 29% emergency admission rate
• 11% of patients are pediatric (<16-years-old)
• 21% of emergency patients arrive by EMS
• 357 trauma activations in 2018

Ancillary staff

• Pharmacist available daily in the department
• 24/7 social worker coverage in the department
• Psychiatrist in the department daily
• Child life specialists available in the department

The Hospital Float Pool is staffed by RNs and CNAs who are trained to work inpatient units, such as medical-surgical, maternal child health, critical care and inpatient behavioral health. Clinic Float Pool staff work in ambulatory departments, such as Family Medicine, General Medicine, Neurosciences, Hematology/Oncology and Pediatrics.

The General Medical Unit is a fast-paced 20-bed unit that cares for a wide variety of acute medical and surgical patients including general medical cases, surgical cases, rule out chest pain, same-day procedures and post heart catheterizations. The General Medical Unit admits both inpatient and observation patients.

The GI Endoscopy Center provides procedural services to patients on an outpatient basis. There is also a fluoroscopy area, where procedures requiring fluoroscopy or negative pressure are performed. Nurses in the GI Lab perform pre-procedure assessment, start IVs, give conscious sedation and monitor patients during the procedure and in recovery. Nurses assist in procedures such as colonoscopy, EGD, ERCP and EUS and complete discharge planning for patients. Staff also travels to Critical Care units to perform procedures on patients.

GundersenAIR is Gundersen's emergency medical helicopter. Providing critical "care in the air," GundersenAIR's highly trained staff have the experience needed to care for critically ill and injured persons, transporting patients from referral hospitals to Gundersen or other tertiary care facilities, as well as flights directly from emergency scene locations. GundersenAIR's flight team members include a critical care/emergency trained nurse and a specially-trained flight paramedic, both skilled in the management of life-threatening emergencies.

Hospice provides a holistic approach for patients and their caregivers on their journey to the end-of-life in the comfort of their home or residence. Hospice is available for adult and pediatric patients within a 50-mile radius of La Crosse. Hospice contracts with nursing homes and assisted living facilities if patients choose to use their hospital benefit. Hospice provides inpatient level of care for those patients who need short term symptom management. The multidisciplinary team consists of nurses who provide comfort care, social workers who assist with end-of-life planning, chaplains who work with all churches and spiritual leaders, bereavement coordinators who support, teach and offer resources to grieving family and friends and hospice aides, who assist with personal cares and volunteers.

Inpatient Behavioral Health offers a healing environment where patients are treated for all mental health concerns. The multidisciplinary team consists of psychiatrists, NPs, RNs, behavioral health specialists, CNAs, social workers, occupational therapists, recreational therapists, clergy and chemical dependency counselors. This team works with patients of all ages, adolescent through geriatric. Many types of group programming are offered, as well as individual counseling. The staff work closely with many agencies in the surrounding area and performs active disposition planning.

Interventional Radiology (IR) performs minimally invasive, image-guided treatment of conditions in every organ system that may have once required open surgery. IR treats a variety of multidimensional diseases and conditions including peripheral artery disease, pulmonary embolism, stroke, cancer, abscess, deep vein thrombosis, kidney failure, liver disease, vertebral compression fractures, uterine fibroids, trauma and bleeding. IR contains two angiography suites, two additional procedural suites, and a patient observation and recovery suite. IR can also perform procedures in the two hybrid operating room suites.

The IV Therapy team consists of RNs, LPNs and IV technicians. This team manages the care and maintenance of select vascular access devices (peripheral IV and central venous lines) for patients on the La Crosse Campus ambulatory and inpatient care areas. Select IV Therapy RN's are trained to place peripherally inserted central catheters (PICC) lines and perform apheresis. The IV Therapy staff educates other nurses, technicians, medical students and healthcare providers on best practices, skills and techniques to access and maintain select vascular access devices.

The Medical & Oncology Unit is a 24-bed unit specializing in the holistic care of oncology and hematology patients receiving chemotherapy or radiation therapy. The unit also cares for patients with acute and chronic medical problems that involve renal dialysis, gastroenterology, endocrinology, dermatology, medical pulmonary, infectious disease and geriatrics. Palliative and Hospice Care services are provided to patients and families facing the end-of-life, while respecting cultural and individual preferences.

The Medical Specialty Unit is a 22-bed unit focused on the care of patients with co-morbid medical and acute behavioral health conditions. Patients include those who are experiencing complications from schizophrenia, major depression, psychosis, anxiety, alcohol or drug overuse. Other commonly treated diagnoses are cellulitis, pancreatitis, cirrhosis and acute kidney injury/disease. Some patients are unable to safely care for themselves at home, may be at risk for suicide or on a Chapter hold. Nurses provide full scope of care, partnering with hospitalists and behavioral health specialists.

Gundersen has a 14-bed, Level 3 Neonatal Intensive Care Unit (NICU) and a 4-bed Pediatric Intensive Care Unit (PNICU) which cares for premature infants and those who have special needs up to age 18. The nurses are part of an interdisciplinary team which includes medicine, nursing, pharmacy, social services, nutrition services, physical therapy, speech therapy, pastoral care, health unit coordinators, patients and families. Nurses are skilled at caring for the diverse and critical healthcare needs of each patient and family.

The Neuroscience Center consists of Neurosurgery, Neurology, Physical Medicine & Rehabilitation, Pain Medicine, Neuropsychology and Speech-Language Pathology. Nurses provide patient care through both telephone triage and nurse-only visits in the clinic setting. The nurse-only visits include disease process education, pre- and post-op teaching and management of surgically implanted devices. Over 4,000 nurse visits occur every year. The scope of practice for the RN in the Neuroscience Center is utilized to its full potential which makes it a very rewarding and gratifying place to work. 

This 24-bed unit offers a variety of learning experiences utilizing an interdisciplinary approach and patient/family centered nursing care philosophy. The unit also has 4 beds equipped for long-term monitoring of patients with seizure disorders. RNs and CNAs partner in the delivery of care. Neurosurgery patients include those who have had spinal surgeries, deep brain stimulators, brain tumors/lesions, aneurysm treatment, and endovascular stroke treatment.

Gundersen Health System is a Joint Commission Certified Primary Stroke Center offering the latest advances in stroke treatment. All nurses on this unit are certified to use the National Institutes of Health Stroke Scale.

Labor & Delivery provides care to all pregnant women in a unit with triage rooms, birthing suites and a birth center for low-risk women who desire a home-like birth experience. Approximately 1,500 births occur here every year. We believe that birth is one of life's most significant events and our nurses care for patients and families using individualized birth plans.

Obstetrics and Nursery is a 14-bed unit focused on the care of new mom and baby couplets. We practice family-centered and are Baby Friendly certified which encourages moms and babies to remain together constantly. Care is taken to balance the physical needs of the woman and her newborn with educating the family on the transition to parenthood.

This is a 24-bed inpatient medical/surgical unit where staff deliver individualized, patient- centered care in a healing environment. Orthopedic patients come in with fractures, joint replacements and major or minor trauma. Patient care teams are composed of RNs, CNAs, HUCs and an Orthopedic tech to deliver the best care to patients.

The Pre-Admissions unit provides care for inpatients and admission day surgical patients, along with patients that present for a same day surgery procedure. Our nurses complete the patient admission and education, while offering individualized care prior to surgery. For same day surgery patients, nurses provide recovery care through to discharge.

This 12-bed unit provides multidisciplinary, family-centered nursing care for infants and children through age 18 years. Pediatrics cares for a wide variety of medical and surgical diagnoses, including oncology and congenital conditions. Care is individualized and various educational techniques are utilized to ensure optimal health outcomes are achieved. The multidisciplinary team also includes Child Life Specialists, CNA's and therapists.

The Pre-Operative Care Unit (PACU) has 44 beds where patients are prepared for surgical procedures. The 23-bay PACU is designed to provide short-term, intensive care to patients during their immediate post-operative recovery. Nursing staff continuously assess each patient's status and provide for maximum comfort and safety.

Nurse quality improvement specialists (QIRN) serve as consultants to nursing management and staff providing expert advice, research, education and tools that enable them to continually improve the care we provide to patients. QIRN's are change agents who facilitate improvement projects, safety huddles, event reporting, data collection and measurement and analyze processes on units to determine how to standardize work. They work with all members of the intra-disciplinary team to ensure that each patient is receiving the best and safest care possible.

As an outpatient treatment center, Radiation Oncology uses high energy x-rays to treat cancer. An interdisciplinary care team, including MDs, RNs, medical assistants, radiation therapists, radiation physicists, dosimetrists, social workers, dieticians, palliative care services, family counselors, spiritual care and hereditary cancer services work together to provide optimal medical care using the latest technologies. A wide range of treatment modalities are available. Nurses in this department are trained to provide ongoing education, consistent hands-on patient care to manage treatment side effects and provide emotional and physical support.

Rehabilitation nursing is a specialty nursing practice which teaches nursing techniques to help patients and their families develop the self-care skills necessary to move toward wellness on the illness-wellness continuum. Our 16-bed inpatient unit offers a setting for nurses to promote independence through involvement with patients, families and an interdisciplinary rehabilitation team. Carefully planned interdisciplinary programs help patients regain or maximize ability to function at home, work and in the community. Our patient population includes individuals affected by brain injury, stroke, spinal cord injury, amputations, and debility due to prolonged illness. As nurses engage in this work and progressively advance their clinical knowledge and skillset, opportunities to pursue certification as a Rehabilitation Registered Nurse (CRRN) are supported by nursing leadership.

Renal Dialysis staff cares for patients with chronic end-stage renal disease and patients with acute renal failure, both on an outpatient and in-patient basis. Acute Care Renal Dialysis RNs are available 24/7 to provide treatments at the bedside for hospitalized patients. The hemodialysis unit in La Crosse provides care to new dialysis patients. Outpatient hemodialysis is provided in Onalaska Monday through Saturday. There are also several satellite hemodialysis units.

The Surgery department consists of 18 state-of-the-art operating rooms which provide a wide range of surgical procedures, including robotic-assisted and minimally invasive surgeries. We are a Level 2 Trauma Center with an in-house staff available 24 hours per day year round. We employ a multidisciplinary team comprised of surgeons, anesthesiologists, residents, physician assistants, CRNAs, AAs, nurses, surgical technologists, surgical assistants, health unit coordinators, CNAs, center core technologists and environmental assistants.

The interdisciplinary care team on this 24-bed unit provides care for a wide variety of patients, including those needing medically managed digestive care and surgical care ranging from trauma, abdominal, vascular, urology, otolaryngology, bariatric and plastic surgery patients. Nurses frequently work with IVs, hyperalimentation, surgical drains, foley catheters, nasogastric tubes, tracheostomies, ostomies, patient controlled analgesic pumps, epidural catheters, telemetry monitoring, wound vacs and simple or complex dressing changes.

Nurses in this 24/7 department provide compassion, education and expert nursing care to callers. Utilizing their nursing knowledge, critical thinking skills, and a state-of-the-art triage system, nurses triage symptoms and guide callers to the right level of care. Nationally recognized protocols are edited and approved by Gundersen providers, ensuring all advice is based on evidence based practice. Triage calls are handled for any patient in the tri-state area of Wisconsin, Minnesota and Iowa. The department also handles triage calls, per contract, for other hospital systems.