The 8 Best Things About Being a Progressive Care Nurse

Progressive care nurses work with a variety of patients and enjoy the rewards of delivering optimal care to ensure good outcomes for patients not critical enough for an ICU stay but requiring more monitoring than takes place on a medical-surgical unit.

Progressive care units (PCUs) also may be called step down or telemetry units. Patients on these units receive constant cardiac monitoring, as well as medications, self-care teaching and regular assessments. While many patients are dealing with cardiac conditions, some have other high-acuity conditions that require close monitoring.

“There are a lot of benefits to working on a progressive care unit,” said Nicole Sikora, RN, BSN, a staff nurse at Mercy Medical Center in Baltimore.

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8 great aspects of progressive care unit nursing

1. Blend critical care skills and patient interaction

Nurses in progressive care units draw on their critical care and critical thinking skills, but also enjoy being able to talk with their patients.

PCU nursing “gives me a challenge as every case is different, and yet I can still talk with my patients,” said Denise Greene, RN, BSN, a progressive care unit staff nurse and relief charge nurse in Texas and a member of the American Association of Critical-Care Nurses (AACN). “I have an opportunity to get to know that person.”

Sarah Valentin, RN, BSN, nurse manager of University of Kansas Medical Center's Neuroscience and ENT Progressive Care Unit in Kansas City, which has earned a gold-level Beacon Award from AACN, enjoys teaching patients how to become independent again, whether that means providing their own tracheostomy care or enteral feedings.

“It’s rewarding to see patients progress,” Valentin said. “When they are in critical care, the patients are not at that point in their recovery. At progressive care, the patients are working toward, hopefully, a home discharge.”

2. Chance to build strong nursing skills

“It gives you a strong foundation in bedside skills,” Sikora said. “We see a wide variety of patients and diagnoses.”

Progressive care nurses need a strong understanding of cardiac conditions, the ability to read rhythm strips and hold adult cardiac life support credentials, Sikora added. PCU nurses also must possess strong multitasking skills.

PCU nursing in some hospitals, including the University of Kansas Medical Center, allows nurses to specialize. For instance, Valentin works with stroke, epilepsy and otolaryngology patients.

“You see the same things and become really good at it,” Valentin said. “It benefits the patients.”

Those strong nursing skills enable PCU nurses to float to nearly every unit in a hospital, Greene said.

“We have a unique skill set tested on a daily basis,” Greene said. “It challenges your critical thinking skills and intuition.”

3. Teamwork and collaboration

Valentin appreciates the teamwork in her progressive care unit. Nurses pitch in to help each other and answer anyone’s call light.

“We do a really good job coordinating, not just with the doctors and patients, but also the social workers, physical therapists and case managers to come up with the best plan for these patients,” Sikora added. “The teamwork is great here.”

4. Rewards for challenging work

“The rewards outweigh challenges because we give back to our community,” Sikora said. “Mercy serves an underprivileged population. It’s rewarding to help educate and care for this population.”

Mercy Medical Center’s underserved population attracted Sikora to the hospital several years ago.

The COVID-19 pandemic also presented challenges for progressive care nurses. The nursing shortage has resulted in higher acuity patients and higher numbers of patients per nurse.

“We are still giving really good care,” Valentin said. “But it has been hard.”

Many of Valentin’s typical patients—those with epilepsy and ear, nose and throat surgeries—were not admitted or rarely admitted during the pandemic, to make room for critically ill coronavirus patients. Additionally, a stroke-certified PCU nurse accompanied stroke patients with COVID-19 who were transferred to a COVID-specific unit, but most of those patients were critical enough to require ICU-level care.

“Nurses have upheld the healthcare system,” Valentin said.

5. Ability to earn a good living and advance

While none of the nurses interviewed for this story brought up monetary rewards, PCU nurse jobs pay well. ZipRecruiter reports PCU nurse jobs pay on average $109,061 per year.

Valentin began on her unit in nursing school and became a staff nurse after graduation. She has since moved up to nurse manager.

PCU travel nurses can also earn excellent salaries for short-term assignments, ranging from $1,700 to more than $3,000 per week.

6. Opportunity to join an active association

Valentin and Greene belong to AACN, which offers educational opportunities, a journal, networking, certification preparation, webinars and a major annual conference. Greene is working toward progressive care certification.

“I have resources available to me,” Greene said.

7. Chance to work travel nurse assignments

PCU nurse jobs are among those with the highest demand in travel nursing, with staffing agencies like AMN Healthcare consistently having hundreds of opportunities available. Some hospitals require basic and adult cardiac life support and NIH Stroke Scale credentials. And some prefer nurses with prior travel nursing experience.

Progressive care unit travel nursing allows nurses to choose when and where they work, and provides free housing, travel reimbursements and a number of other benefits.

8. Satisfaction with a job well done

Progressive care unit nursing gives Sikora a sense of purpose.

“I am able to go home knowing I helped other people,” Sikora said. “To know you have made an impact on someone’s life, no matter how small, and being part of that healing process is a unique skill to nursing.”

Valentin enjoys when her former patients return to visit and are doing well. Some of the patients with epilepsy are able to drive again, regaining their independence after the PCU team found solutions to their health conditions. That gives her satisfaction.

“I love being a PCU nurse,” Greene concluded. “I try to be the best I can.”

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