Nursing at MedStar Washington Hospital Center

Emergency Department and MedSTAR
(Medical Shock Trauma Acute Resuscitation)

The Emergency Department RN Residency offers extensive orientation for newly graduated nurses and nurses wishing to specialize in emergency nursing. We have an international reputation for the quality of care provided in our emergency department and trauma center, with more than 85,000+ visits in FY 2012. MedStar Washington Hospital Center is a national leader in emergency preparedness spearheading efforts to improve the National Capital Region's ability to respond to mass casualty incidents.

Emergency Department (ED)

The ED includes a triage area, 50-bay acute treatment area and nine-bed ambulatory care area. We are one of approximately 20 hospitals nationwide designated as a Primary Stroke Center by The Joint Commission.

MedSTAR (Medical Shock Trauma Acute Resuscitation)

The American College of Surgeons consistently recognizes the MedSTAR (Medical Shock Trauma Acute Resuscitation) Trauma program as one of the nation's best Level I shock/trauma units. MedSTAR It is a resource for transport and treatment of a wide spectrum of critical illnesses and injuries across the mid-Atlantic region.

Our flight and ground RN staff are trained to provide resuscitative emergency and critical care transport services. Nurses must have a minimum of two year's critical care experience to work in MedSTAR.

Physicians from all medical specialties are available on a 24-hour basis, including specialists in neurosurgery, oral and maxillofacial surgery; otolaryngology; plastic surgery; orthopaedics; urology; cardiovascular surgery; microvascular surgery; burn treatment; neonatology and obstetrics/gynecologyFacilities include six resuscitation areas, an operating room and equipment to assess, diagnose and treat life-threatening illnesses or injuries. The three MedSTAR teams, in-house 24 hours a day, including MedSTAR and intensive care nurses, two attending physicians, a team fellow, surgical residents, a respiratory therapist, a MedSTAR paramedic, a cardiovascular technician, a blood bank technician and an X-ray technician.

For more information, please contact Human Resources at 202-877-7447.

Medical-Surgical nursing at MedStar Washington Hospital Center is challenging and provides our nurses with the opportunity to provide evidence based nursing care to a diverse patient population using leading-edge technology. Patient care is provided using an interdisciplinary approach involving the patient, nursing, medical staff, pharmacy, laboratory, pathology, respiratory therapy, spiritual care, nutritional services, rehabilitation and radiology.

We are one of only 2 hospitals in the District of Columbia, who has been designated by NICHE (Nurses Improving Care for Health System Elders) as providing excellent patient -centered, evidence-based geriatric care. Nurses on our Medical-Psychiatric unit receive specialized MANDT training and have the support of a full time psychiatric educator to assist in managing the unique needs of patients with both medical and mental health issues. Our nationally recognized Burn-Trauma unit cares for patients with traumatic and thermal injuries. The Burn-Trauma nursing team has presented at the American Burn Association annual meeting and is active in burn prevention efforts. Our Orthopedic unit uses an innovative team approach for the care of the patients in our joint replacement program. Patients are assessed before surgery by the surgeon, the Post Acute Care Coordinator, a rehab specialist and a home care nurse to develop a plan of care that spans the continuum of care. This collaboration has improved patient satisfaction and decreased the length of stay. Our transplant program is one of the busiest in the nation and has a success rate well above the national average.

Quality and safety are at the forefront of all that we do. Our medical-surgical nurses are dedicated to delivering care that will achieve the best possible outcomes for our patients. Each nursing unit closely monitors nurse sensitive indicators and core measures to assess the quality of the care that is delivered. A quarterly award is given to those units meeting or exceeding the benchmarks.

Our RN Residency offers a comprehensive education and orientation program. We are committed to supporting the professional development of all of our nurses and offer a generous benefits package to support your educational goals.

Medical Surgical Nursing

Inpatient Units

Our highly acute 195 bed medical and surgical units provide care to a population with a variety of multi-system acute and chronic medical conditions, as well as surgical intervention and care. The primary medical diagnoses are ESRD, pneumonia, CHF R/O tuberculosis, HIV and diabetes.

Select units have subspecialty foci of GI disorders, geriatrics, renal disease including renal transplants and diabetes. Many units have advanced care options such as telemetry and ventilators.

For more information, please contact Human Resources at 202-877-7447.

Washington Cancer Institute

In FY10, we diagnosed more than 2,300 new cancer cases and had more than 85,000 outpatient visits. MedStar Washington Hospital Center performs more cancer-related procedures than any other hospital in the Washington, D.C., region. We use cutting-edge, evidence based technologies to detect, diagnose and treat cancer. Our services include surgical, radiation and chemotherapy treatments, a patient education and community support center, and access to other support services.

Oncology nurses provide care to patients with a wide variety of oncologic diagnoses and related disorders in inpatient and outpatient settings. As members of the healthcare team, we use an interdisciplinary, holistic approach in caring for our patients. Our Oncology Navigator Program uses specialized nurses to assist patients, families and care givers to navigate the health care system and to ensure that the patient is receiving quality care throughout the continuum of care. Our Medical Oncology practice has received the Quality Oncology Practice Initiative certification from the American Society of Clinical Oncology. This certification demonstrates a commitment to providing quality oncology care.

Our nurses are actively involved in the National Coalition for Oncology Navigators, the Oncology Nurse Advisory Board and Oncology Nursing Society. Our Clinical Specialist and Navigators have provided scholarly poster presentations at national forums and have published in scholarly journals.

If you wish to specialize in oncology, we offer a supportive educational environment, including a Chemotherapy and Biotherapy Certification course sponsored through the Oncology Nurse's Society. We are committed to supporting the professional development of all of our nurses and encourage all of our professional nursing staff to pursue professional certification. We offer a generous benefits package to support your educational goals.

Cancer Institute

Provides ambulatory diagnostic, treatment and supportive/palliative services to patients with a wide variety of oncologic disorders, particularly pre-operatively and post-operatively. Specific services include Breast Surgery, GI/Onc, Gyn/Onc, Orthopedic/Onc, Pain, Palliative Care, Melanoma and Urologic/Onc. The infusion center provides outpatient infusion services. The Department of Radiation Oncology provides inpatient and outpatient radiation therapy services for cancer patients at the Washington Cancer Institute.

Oncology Specialty Center

OSC sees patients with various oncology diagnoses for pre-operative and post-operative care. Types of patients seen in this clinic include thoracic, GI, Urological, Orthopaedic, Pain and palliative care, and Melanoma.

Women's Oncology Center

WOC sees patients with breast cancer and gynecological cancer.

Medical Oncology

Medical oncology sees patients with that require medical management for solid and non-solid tumors. Non-oncology hematology patients are also seen in this clinic.

Infusion Center

The 21 bay infusion clinic sees an average 40 patients per day. Patients receive chemotherapy, hydration, and blood transfusion. The Infusion center also performs bone-marrow biopsy.

Radiation Oncology

The busy Radiation oncology department sees on average 100 patients per day. This clinic provides services to both inpatient and outpatient.

For more information, please contact Human Resources at 202-877-7447.

MedStar Washington Hospital Center has a total of 33 operating suites supporting our extensive operative services.

Our RN Residency program in Perioperative Services is offered for RNs with one year of Med/Surg experience and no perioperative experience. The program to prepare an RN for the operating room consists of three weeks of classroom instruction, followed by six-eight months of clinical orientation. Nurses preparing to work in the preoperative and postoperative areas will attend 5 days of classroom instruction and approximately 10 weeks of clinical orientation covering both the preoperative and postoperative areas.

Main Operating Room and the Post-Anesthesia Care Recovery Room (PACU)

This area has 21 operating suites and 2 satellite operating suites. Perioperative Services perform 25,000 surgical cases annually. Many of the cases in the Main Operating Room are cutting edge, complex and include Trauma, Open Heart, Neurosurgery, Transplant, Orthopedics and Oncology. Other specialties include a state of the art Endovascular Suite and Robotics. The Post-Anesthesia Care Recovery Room (PACU), a leading edge space designed to support critical care nursing, is one of the few in the country with an acute care nurse practitioner practicing daily on the unit providing tremendous support to our nursing staff. It includes a 24/7 system with 17 bays to recover patients from surgery in the main operating room system. The majority of these patients go to a medical-surgical nursing unit or to intensive care after recovery. Care is coordinated and directed in a team oriented process.

Admission Testing Center

ATC provides preoperative assessment and testing for AM admit and outpatients who require anesthesia services, prior to their surgery/procedure date. This can include a history and physical, lab work, and ECG. In addition to skilled registered nurses and phlebotomists, the ATC staff includes advance clinicians (Nurse Practitioners and Physician Assistants) who are trained by the anesthesiology team to provide thorough and safe pre-anesthesia assessment and clearance. The ATC is open Monday through Friday for patient convenience.

Ambulatory Operating Room

Open Monday through Friday, the third floor unit includes eight operating rooms, a burn debridement room, two treatment rooms, preoperative preparation and recovery. Surgical specialties served in this area include (but are not limited to) renal vascular, urology, gynecology, burns and ophthalmology surgeries. It also houses a robot used for urology surgeries.

Same Day Surgery Recovery Room

This unit cares for both in-house and newly arriving patients with 18 preoperative preparation bays and 6 post-operative recovery bays. Our anesthesiology pain team works closely with the nursing staff to optimize pain management in the early postoperative period. Patients having same day surgery recover from anesthesia and, when appropriate, are prepared for discharge to home the same day. Same Day surgery nurse conduct postoperative phone calls within 48 hours of discharge to follow up on outpatient recovery.

Endoscopy Suite

The endoscopy suite has 8 procedure rooms. Serving a mix of inpatients and outpatients, this unit performs a variety of endoscopic and diagnostic procedures including colonoscopies, ERCP, EGD, bronchoscopies, hydrogen breath tests and motility studies.

The MedStar Washington Hospital Center's Critical Care and Neuroscience department provides the most critically ill patients with expert care unsurpassed in the mid-Atlantic region. Every day, interdisciplinary teams collaborate and implement thoughtful, innovative medical and nursing care for patients with a variety of complex medical and surgical diagnoses. This high energy, high acuity department not only provides the best in patient care, it offers nurses the opportunity to experience the most challenging and exciting aspects of nursing.

The possibilities for professional growth are endless. Our nurse leaders support and encourage nurses to pursue their interests and professional goals. Access to educational programs either leading to specialty certification or an advanced degree is available. Our experienced nurse leaders, nurse educators and nurse researchers are available to mentor staff in public speaking, evidenced based research, and writing for publication. Whether you are a new or experienced nurse we believe you will be able to fulfill your career goals at MedStar Washington Hospital Center.

Our Critical Care & Neurosciences RN Residency offers individually-planned orientation for experienced nurses and newly graduated nurses wishing to specialize in critical care and neurosciences care.

• Trauma
• Neurology
• Neurosurgical
• Open heart
• Vascular surgery
• Medical and general surgery
• Adult burns

As an established leader in cardiovascular care for more than 50 years, the team at MedStar Heart & Vascular Institute at MedStar Washington Hospital Center performs more than 3,500 stress tests, 11,000 echocardiograms and 75,000 electrocardiograms each year. We are the busiest heart catheterization center in the United States, performing more than 19,000 procedures annually, and we lead the region in number of open heart surgeries per year.

The program, rated in the top 20 heart centers in the country by U.S .News & World Report offers patients highly specialized diagnostic tools and treatments and procedures for a variety of heart diseases and conditions. Patients from around the world are drawn to the excellent care and state-of-the-art diagnostic technology at MedStar Heart & Vascular Institute. Our nurses work tirelessly to provide world-class nursing and rehabilitative care for our heart and vascular patients, minimizing recovery times and returning patients to daily life faster. Providing a supportive and efficient treatment center for patients and families is a critical part of our mission.

The entire staff at MedStar Heart & Vascular Institute is dedicated to pushing the boundaries of heart and vascular care. That is why we have an unrivaled research capability, the Cardiovascular Research Institute, dedicated to uncovering best practices in heart and vascular care. A part of MedStar Health Research Institute, a regionally acclaimed hub of state-of-the-art research protocols and clinical trials, this facility is making strides toward better treatment and prevention for cardiovascular health.

MedStar Washington Hospital Center is the only hospital in Washington, D.C., and suburban Maryland to offer advanced heart failure patients a chance to improve their quality of life with the left ventricular assist device (LVAD). This mechanical circulatory assist device helps pump blood for an ailing heart. Surgeons implant the device inside the body and an external battery pack keeps the LVAD operational. Patients see an improved quality of life and can return to productive work and enjoyable activities. An LVAD might be an option for patients waiting for a heart transplant and those who are not candidates for a transplant. The Hospital Center is the first in the region to be certified and recertified the use of the LVAD by The Joint Commission. Outcomes for the LVAD program at the Hospital Center exceed national benchmarks.

MedStar Washington Hospital Center is one of two hospitals in the District to receive official notification that we earned the Quality Excellence Award from the Delmarva Foundation. The foundation only bestows this honor on hospitals that achieve a compliance score of 90 percent or higher - for three consecutive quarters in a calendar year - in 16 required clinical measures that fall under four clinical areas - heart attack, heart failure, surgical care improvement and pneumonia.

Our nurses in the MedStar Heart & Vascular Institute continually strive to provide safe, evidence based care that achieves quality patient outcomes. Several members of our team have presented both posters and lectures at both local and national nursing and critical care conferences. Our team includes nationally-published authors and researchers. We are committed to the ongoing professional development of our nurses and provide many opportunities for growth and development for both the new and experienced nurse. We are especially proud of our Cardiac Services RN Residency which offers a comprehensive education and orientation program.

Women's Services perform an average of 4,000 deliveries each year. With our nationally-recognized NICU, patients with high-risk pregnancies and complex circumstances receive expert, compassionate care. Our unique program, Special Moms and Special Babies, coordinates the delivery of mothers whose babies require more specialized care by Children's National Medical Center, including conjoined twins, cardiac abnormalities and other conditions requiring neonatal surgery immediately after delivery.

The Women's and Infants' Services team has been acclaimed for several evidence-based perinatal safety projects, including critical event team training, daily multi-disciplinary huddles and extensive advanced education for all patient care providers. Additionally, several members have presented innovative posters and given lectures at local and national nursing conferences, and this team includes nationally-published authors and researchers. The successful, interdisciplinary labor and delivery council provides shared governance, empowering unit staff to identify issues, then develop and implement strategies to improve all aspects of patient care.

Nursing residencies cover the spectrum of our women's and infants' services, and include AACN-courses in fetal monitoring and advanced practice strategies' modules, labor support, high-risk pregnancies and deliveries, circulating in the operating room, certification in neonatal resuscitation, breast feeding, postpartum care of mothers and normal neonates and care of preterm or sick neonates.

Labor and delivery

The labor and delivery suite consists of four observation/triage rooms, three observation/recovery rooms, 12 labor/delivery/recovery rooms, three operating rooms and one observation/recovery area with five bays. Nurses provide proficient, compassionate family-centered care for women 16 weeks pregnant and beyond. We provide comprehensive clinical care and support for antepartum, intrapartum, and postpartum patients with needs that range from uncomplicated to those with the most complex physical and emotional issues. These include patients with mild to severe preeclampsia, diabetes, kidney disease, cardiac disease, hematologic/oncologic disease, obesity, congenital disorders, etc.

Working collaboratively with Children's National Medical Center, our "Special Moms, Special Babies" program coordinates the deliveries of babies requiring the immediate attention of the specialists at CNMC.

We have an extensive bereavement program for patients and families experiencing fetal or neonatal loss. Our nurses are trained to circulate on surgical cases, including Caesarian sections, tubal ligations, and D and Cs, as well as recovering these patients, including those who have received general anesthesia.

Mother/Baby and High-Risk Antepartum

These inpatient units include 36-bed ante-partum and post-partum units and a 17-bed newborn nursery. Nurses provide both ante-partum and postpartum care on both units. We provide care for diabetic patients, preterm labor surveillance, gestational hypertension surveillance and other conditions that require acute or extended hospitalizations.

We offer an environment where there is a family centered focus with great emphasis on providing excellent support and education to the mother and family in the care and well being of the newborn. We provide excellent support and education in exclusively breastfeeding to provide the very best start for our smallest patients. The nursing staff is supported by the clinical expertise of Clinical Care Facilitators (CCF).

Newborn Nursery

The newborn nursery is used for normal newborns undergoing assessments and procedures (such as circumcision), as well as the care of newborns with hyperbilirubinemia & other minor complications.

Neonatal Intensive Care Unit
Level III NICU (Neonatal Intensive Care Unit) and Intermediate Care Nursery

There are 36-beds Level III NICU providing care for neonates with gestational age range from 23- weeks to full term (40+ weeks) neonates. The primary diagnosis is prematurity, respiratory distress, resulting in infants requiring ventilator support, incubator support, cardio-respiratory monitoring and frequent observation. Care is also provided to neonates with presumptive or diagnosed sepsis, aspiration pneumonia, gastrointestinal diseases, reflux, feeding difficulties and other disease processes.

Newborns are admitted from the Labor and Delivery Suite. Infants requiring surgical intervention are transported to Children's National Medical Center by their medical team. Siblings are allowed scheduled visits.

High Risk Perinatal Clinic

Our team of well-respected perinatologists, genetic specialists, sonographers and nurses provide highly-specialized outpatient care and consultation to women with medically and/or emotionally complicated pregnancies with dignity and respect.

OB-GYN Clinic

The OB-GYN clinic provides primary care and ambulatory diagnostic, treatment and education; pre/post natal services to normal and high risk pregnancies and OB-GYN care to women of all ages. Patients are referred as inpatients, by their physician or make an appointment on their own.

The OB-GYN services include colposcopy, infertility, family planning, post menopausal and urogynecology services. The OB-GYN clinic provides services to high risk groups, such as gestational diabetics and those with HIV infection.

 For more information. please contact Human Resources at 202-877-7447.

Nurses are a critical member of the multidisciplinary team in the Ambulatory Care Areas. Nursing care is provided by the clinical nurse coordinators who coordinate assessment and care of patients, and supervise the Medical Assistants who provide much of the direct patient care. The clinical nurse coordinators assess and educate patients, troubleshoot problems, coordinate care for patients and serve as a liaison between clinical staff and patients and community resources. Other services provided by referral include nutritional assessment and counseling, psychiatric assessment and counseling, MedStar Health Home Care, home infusion, PT, OT and speech therapy. Nurses assist with specialized procedures which are performed in the clinic areas such as IV infusions of iron and infliximab, endocrine testing, and oral surgery procedures.

Patient education is an important component of care provided in the ambulatory care, with most education provided one-to-one, based on assessment of patient needs and possible barriers to learning. Services also include patient education and information packets, resource materials and support group information. Group classes for diabetic patients are provided in the Medical Ambulatory Clinic, which are linked to the inpatient and home care diabetic teaching program. Preoperative education is provided in the Surgical Clinic. The transplant clinic provides specialized education and patient support groups.

Ambulatory Care

Provides diagnostic and therapeutic services, interdisciplinary care coordinator, patient education and community support services, and palliative and supportive care.

Medical and Medical Specialties Clinics

Provides interdisciplinary primary care for adult patients in the ambulatory arena. In addition to the general medical clinics, there are specialty clinics for Rheumatology, Geriatrics, Endocrinology, Cardiology, Pulmonary, Nephrology, Infectious Disease, and Gastroenterology. A special team approach has been established for managing the care of patients with the diagnoses of CHF, Stroke, Diabetes, and HIV.

Oral Surgery Clinic

Provides comprehensive oral surgery health care that includes evaluation, immediate care, pre- and post-operative care out-patients. The range of services extends from the management of simple tooth abscesses to the replacement of teeth with dental implants, to the treatment of severe facial infections, facial trauma, facial malformation, and tumors of the jaw.

Surgical Clinic

The surgical clinics provide management of those patients that are pre- and post-surgical procedures, as well as ambulatory diagnostic, treatment and education to patients with a variety of problems. The surgical clinic offers programs in orthopedics, general surgery, urology, bariatric plastics, ostomy, neurosurgery, vascular, podiatry, trauma and pain.

ENT Clinic

The ENT Clinic provides surgical pre and postoperative follow-up and ambulatory diagnostic; treatment and education. Patient's ages range from adult to geriatric adult. Patients are referred with a wide variety of ear, nose and throat problems. Many patients have multiple or chronic medical and social problems, which experience frequent hospitalizations, and are followed in more than one clinic at MedStar Washington Hospital Center

Transplant Clinic

Provides care for both pre and post transplant patients. The multidisciplinary team provides:

• Recipient evaluation, education and preparation for kidney transplantation.
• Living donor evaluation and advocacy, education and preparation for kidney donation.
• Recipient follow-up care, education and services.
• Patient registration on the national waiting list.
• Clinical coordination with organ procurement organizations to obtain suitable organs for recipients.
• Professional and community education programs regarding transplant and organ donation.
• Patient support group, advocacy and community involvement.

For more information. please contact Human Resources at 202-877-7447.