The following is a list of participating departments in the Adult RN residency program.

Departments

Medical Intensive Care Unit

  • The Troesh MICU (8A) is a 32-bed unit that provides intensive nursing care for adult patients treated for problems involving multiple organ systems, including pulmonary, cardiac, gastrointestinal, neurological, endocrine, renal and hepatic systems. The most common treated problems include respiratory failure, sepsis, gastrointestinal bleed, diabetic ketoacidosis and pneumonia. Frequent procedures, services, and functions include cardiac and hemodynamics monitoring, central line management, management of artificial airway and mechanically ventilated care, enteral/parenteral nutrition support, wound care management, ICP monitoring, intubation, tracheostomies, chest tubes, and continuous renal replacement therapy (CRRT).
  • The East Campus Hospital MICU (1400) is an 8-bed unit that provides intensive nursing care for adult patients that are critically ill and in need of active, intensive treatment, including: Respiratory failure, DKA, PE, septicemia, and CHF. Frequent procedures, services, and functions include management of mechanically ventilated patients with advanced airways, blood transfusion, pain management, management of wounds and drains, cardiac and hemodynamic monitoring, and central line monitoring and care. 

Surgical/Neuro Intensive Care Unit

  • The Troesh Surgical, Trauma, Transplant and Neuroscience ICU (7A) is a 32-bed unit that provides high acuity clinical-care for age-appropriate adolescent and adult patients. Common diagnoses include a complex variety of strokes, high-morbidity trauma victims, and post-op surgery care. These patients need continuous cardiac and hemodynamic monitoring, often coupled with titratable vasoactive intravenous medications, continuous IV fluid replacements, continuous renal replacement therapy (CRRT), and frequent neurological evaluations and interventions such as intracranial pressure (ICP) monitoring, ventriculostomies and/or lumbar drains. 

Cardiac Intensive Care Unit

  • The Troesh Cardiac and Cardiothoracic ICU (9A) is a 32-bed unit that provides comprehensive adult nursing care for adult patients, including the medical or surgical treatment of cardiac, thoracic, or vascular diseases. This unit treats patients requiring, or having previously had, procedures or surgeries on the heart, lungs, the great vessels, or the esophagus. Frequent procedures, services, and functions include continuous cardiac and hemodynamic monitoring, vasoactive medication titration, ventilation management, and ongoing cardiac evaluation of patients who may require ventricular assist devices. These include intraaortic balloon pumps, continuous renal replacement therapy (CRRT), ECMO, or open chest. 

Neuro Progressive Care

  • The Troesh Neuroscience Progressive Care Unit (13A) is a 32-bed unit that provides advanced acute / intermediate neurological nursing care for adult patients. This unit treats problems including but not limited to ischemic strokes, hemorrhagic strokes, seizures, neurosurgical procedures, and other neurological problems. Frequent procedures, services, and functions include continuous cardiac and hemodynamic monitoring, ongoing neurological evaluation, maintenance of intracranial pressure (ICP) monitoring, maintenance of continuous IV blood pressure medications, ventriculostomies and lumbar drains, and stable conventional/non-conventional ventilator management. 

Medical Progressive Care

  • Troesh has multiple medical progressive care units (11A and 12A *32-beds each) that provide acute/intermediate nursing care for adult populations in need of a variety general medicine services. Nursing care can include continuous cardiac monitoring, pain management, nutritional support (TPN, enteral feedings), and wound care. Additionally, these units support patients with cardiac conditions, VEEG monitoring for seizure activity, and neurological needs, including stroke care at both acute and step-down levels.
  • The East Campus Hospital Medical Acute Care Unit (1300) is a 31-bed unit that provides care for adult medicine patients requiring acute and intermediate care for CHF, DM, renal failure, UTI, COPD acute exacerbations, VTE, sickle cell crisis, pneumonia, and more. Frequent procedures, services, and functions include post-procedure care, patient-controlled analgesia, cardiac monitoring/telemetry, blood administration, central venous line placement and care, lumbar puncture, and GI procedures.  

Surgical Progressive Care (Cardiology, Orthopedics, and General)

  • The Troesh Cardiac Progressive Care Unit (10A) is a 32-bed unit that providesadvanced cardiac nursing care for adult patients requiring intermediate or acute care within a cardiac medicine and surgical setting. Most patients are under cardiac, thoracic, or vascular services. Bedside procedures requiring sedation — such as transesophageal echocardiograms and cardioversions — are performed frequently. Nursing care also includes managing interventional cardiology patients, those receiving non-titratable continuous cardiac IV infusions, step-down ventricular assist device (VAD) patients, and individuals with pulmonary hypertension receiving prostacyclin therapy.
  • The Troesh Surgical and Trauma Care Units (14A and 15A) are inpatient units with 32 beds each, providing acute and intermediate levels of care to surgical and multi-system trauma patients. The unit provides continuous nursing care adults under the care of the following services: Acute care surgery, general surgery, gynecological surgery, ENT surgery, surgical oncology, orthopedic surgery, plastic surgery, urological surgery, and other specialty surgical services. Nursing care is designed to support individuals needing continuous cardiac monitoring, pain management, nutritional support (TPN, enteral feedings), and wound care.
  • The East Campus Hospital Surgical Care Unit (1200) is a 31-bed unit that admits adult patients requiring acute and intermediate post-operative care for surgical, orthopedic, and neurosurgical procedures. Most commonly treated diagnoses include osteoarthritis, rheumatoid arthritis, degenerative joint disease, herniated disk, spondylolysis and plastic surgery care. Frequent procedures, services, and functions include post procedural care, telemetry, blood administration, central line management, care and assessment of traction, external fixation devices, and immobilization devices, and wound management.
  • The Surgical Hospital Surgical Care Unit (2100) is a 24-bed unit that provides comprehensive nursing care for adult patients requiring intermediate or acute care for what are usually postsurgical or post-procedure conditions. Nursing care focuses on frequently performed procedures such as ENT procedures, minimally invasive surgical procedures, post-interventional radiology procedures, robotic procedures, urological procedures, uro-gynecological procedures, laparoscopic or vaginal hysterectomy, bariatric procedures, breast reconstruction and mastectomy, cosmetic plastic surgery and laparoscopic cholecystectomy, and colectomy.

Oncology

  • The Troesh Oncology Unit (6A East) is a 16-bed inpatient unit providing acute and intermediate levels of care to oncology patients. The unit provides continuous nursing care for adults under the care of the following services: Medical hematology/oncology, surgical oncology, gynecology oncology, radiation oncology, and palliative care. nursing care is designed to support patients requiring chemotherapy, radiation therapy, blood and marrow transplant and immune effector cell therapy, continuous cardiac monitoring, pain management, nutritional support (TPN, enteral feedings), and wound care.

Transplant

  • The Troesh Transplant Unit (6A West) is a 16-bed unit that provides acute and intermediate levels of care to patients requiring or having previously had renal, renal/pancreas, pancreas, or liver transplants, as well as donor nephrectomies. The unit provides continuous nursing care for adults under both transplant and hepatology services. Nursing care is designed to support patients requiring pre- and post-surgical care, continuous cardiac monitoring, pain management, nutritional support (TPN, enteral feedings), and wound care support.

Rehabilitation

  • The East Campus Hospital Rehabilitation Units include a 31-bed unit (1100) and a 24-bed unit (1500) and serves patients requiring comprehensive acute care rehabilitation. The most common diagnoses are stroke, traumatic brain injuries, spinal cord injuries, amputation, burns/wound care. Frequent procedures, services, and treatments include safety management, comprehensive patient/family education, neurogenic bladder/bowel management, tracheostomy care, CPAP/BiPAP, hemodynamic and autonomic dysreflexia management, and enteral/parental nutrition management. California Children Services (CCS) standards allow licensing of pediatric patients (ages 14-20 years old) to be provided care. 

Behavioral Health

  • The Behavioral Medicine Center (BMC) is an 89-bed, 24-hour hospital specializing in acute psychiatric care for children, adolescents, adults, and geriatric patients, as well as those recovering from substance use disorders. The center treats a wide range of conditions including depression, anxiety, schizophrenia, bipolar disorder, eating disorders, and mental health challenges related to chronic illness, across both locked and unlocked units. Frequent procedures, services, and functions include chronic pain management, crisis intervention/stabilization, dual diagnosis, eating disorder treatment, psychotherapeutic care, medical detoxification, medication administration, nutritional management, and psychological testing.

    *Not a designated medical-psychiatric level of care facility but maintains medical consultant support services.

Adult Emergency Department

  • The Troesh Emergency Department (ED) is a tertiary care facility with level one trauma, a comprehensive stroke center and STEMI center which provides quality healthcare to adult patients who present with life-threatening, rare and complex medical conditions. Frequent procedures, services, and functions include resuscitation, cardiac pacing, ECG interpretation, transfusions, intubations, foreign body removal, pain management, orthopedic interventions, lumbar puncture, and STEMI and stroke evaluation and treatment. 

Perioperative Services (Operating Room, Preoperative/Post-Anesthesia Care Unit)

  • The Perioperative Services for Loma Linda University Health is a conglomerate of OR sites, perianesthesia (preoperative and recovery) units, and procedural areas within the system. Perioperative nurses provide care, ensure patient safety, continuity, and quality of care prior to, during and after surgical and invasive procedures.
    • Troesh, a Level One Trauma Center which provides 24-hour surgical services for higher acuity outpatient procedures, and hospitalized patients undergoing cardiac, transplant, vascular, neurosurgery, oncology, trauma, and emergency surgery.
    • Surgical Hospital, which offers specialized elective ENT, GYN, urological, and general surgery. It is also the Loma Linda System’s main center for robotic surgery.
    • East Campus Hospital, which focuses on orthopedic surgery such as total joint replacements, sports medicine, spine surgery, plastic surgery, and oral-maxillo-facial surgery.

Observation Units

  • The Hinshaw Towers Observation Units (8100, 8200, and 8300) are designated to accommodate outpatient observation or extended care. With 26 beds in each unit, the staff provide nursing care for adults in need of a variety of general medicine, surgical, and cardiology services, prior to getting discharged. *Not a same day surgery or recovery room observation unit.

Advanced Urgent Care

  • The East Campus Hospital Advanced Urgent Care (AUC) is a 11-bed outpatient clinic which provides 24-hour care for pediatric and adult patients in need of initial evaluation and treatment of non-life-threatening conditions. The urgent care also evaluates and treats episodic illnesses such as broken bones, minor asthma symptoms, upper respiratory infections, abdominal pain, minor wound care, UTI, and skin rashes. Frequent procedures, services and functions include ECG interpretation, incision and drainage of wounds, minor dressings, minor dislocation reduction techniques, pain management, splinting, and medication administration. 

    * Operates as a scaled-down emergency department

Murrieta

  • The Intensive Care Unit (ICU) is a 12-bed unit which provides nursing care for adult patients requiring intensive care for problems involving multiple organ systems including pulmonary, cardiac, gastrointestinal, neurological, endocrine, renal, and hepatic. It also provides intensive care after surgical treatment of cardiac, thoracic, or vascular problems. This population includes, but not limited to, patients requiring or having previously had surgery on the organs of the thoracic cavity, including heart, lungs, the great vessels, as well as other surgical patients.
  • Medical-Surgical is a 28-bed acute care nursing unit providing comprehensive nursing care to adult patients admitted with any acute care needs including: post-operative care, telemetry, orthopedic care, CHF, COPD, pneumonia, DM, wound management, traumatic injury, renal failure, sepsis, and end of life care. Post-operative care includes the following surgical specialties: general, thoracic, orthopedic, GYN, ENT, vascular, urology, and cardiovascular.
  • Medical-Telemetry is a 26-bed acute care nursing unit providing comprehensive nursing care to adult patients admitted with medical diagnoses with a focus on Telemetry. Nursing care focuses in the frequently performed procedure such as: Non-titrating IV infusions, pre/post cardiac cath lab procedures, basic stroke care, surgical patients, and oncology.
  • Cardiac/PCU is a mix of telemetry and progressive care patients in a 26-bed unit. The staff provide nursing care for adult patients who need intermediate level of care and telemetry including DM, wound treatment, renal failure, stroke, STEMI, tracheostomy care, pain management, CHF, sepsis, pneumonia, COPD, seizure disorders, and cardiothoracic surgery/interventional procedures. Nursing care focuses in the frequently performed procedures such as: Telemetry, cardiac monitoring, artificial airway management, central line management, post-procedural care, blood transfusions, wound care, and enteral/parenteral nutritional support.
  • The Emergency Room (ER) provides medical and nursing care to neonatal, pediatric, adolescent, adult, and geriatric patients who present to the Department. The patient population served by this ER will include those patients with non-urgent, urgent, and emergent conditions of all ages as identified by the Emergency Severity Index. Frequent procedures, services and functions include resuscitation, cardiac care, transfusions, foreign body removal, lumbar puncture, orthopedic care, critical care monitoring, and stroke care. 

*Participating departments are subject to change per cohort