Understanding Hospital Floors and Units

Making Sense Out of Hospital Acronyms and Alphabet Soup

Recovering After Surgery
Recovering After Surgery. Image: © Rebecca Ellis/Getty Images

If your loved one is in the hospital, you may be struggling to make sense of all the acronyms in the place.  What does ICU mean and is that different from the SICU or CCU?  The short answer is that all Intensive Care Units (ICU) provide intense monitoring for the patient, but some are more specialized than others.

The following acronyms are frequently used in hospitals to describe where the patient is receiving care before, during and after surgery.

They do vary somewhat between facilities, but are fairly standard in the United States.

ER

The emergency room, also referred to as the emergency department, is where individuals seeking care are first seen after a sudden and serious illness or injury.  Individuals may arrive at the ER by private transportation or by ambulance, and care is provided by severity of illness rather than by arrival time.  This is because an individual who is having a heart attack requires immediately treatment, while those with less serious injuries are able to wait.  The general rule of thumb is that if you can wait to see your own doctor in the morning, your issue is likely not serious enough to warrant a visit to the ER.  On the other hand, serious illness and injuries should result in seeking care immediately.

PACU

The PACU is the post anesthesia care unit, which is where patients are taken after surgery to be closely monitored while their anesthesia wears off.

  A patient typically stays in the PACU for a few hours but may stay longer, depending on availability of a hospital room or if their condition isn’t as stable enough to allow them to be transferred to a regular room to continue their recovery.

OR

The OR, or operating room, is where surgeries are performed.

  Inpatient surgeries and outpatient surgeries are performed in the operating room.

"PreOp" 

PreOp is short for preoperative, which means before surgery. This area is sometimes called same day surgery, outpatient surgery, or preoperative holding. This is the area where patients wait prior to their procedure, and often this is where any necessary medications or IV access are initiated. 

ICU

ICU, or the intensive care unit, is where patients who require close monitoring are sent for care.  The ICU is also referred to as a critical care unit.  The nurse taking care of the patient typically has one or two patients, so the patients here are able to be constantly monitored.  In most facilities, a patient who requires a ventilator to breathe will be cared for in an ICU. 

An ICU, regardless of type, is a place where vital signs can be constantly monitored, and a low nurse to patient ratio allows for close monitoring of the patient at all times.  Critical care units are able to support ventilator

NICU

The NICU may be the neurological intensive care unit or neonatal intensive care unit, depending on whether the facility treats adults or children.

  In some facilities, the neurological ICU is referred to as NCC, for Neurological Critical Care.   

Neurological ICU is where very sick individuals with brain related illnesses are taken for care.  Patients in the Neuro ICU may have illnesses ranging from strokes or seizure disorders to traumatic brain injuries, or may be recovering from brain or spine surgery.  

Neonatal ICU is where newborns are taken for intensive care.  Premature infants, or very sick babies, are treated in the NICU where they can receive constant monitoring. 

PICU

The PICU is a Pediatric Intensive Care Unit, where children receive critical care.  Children are treated in the PICU, and depending on the facility, newborns may be treated in a PICU or a Neonatal ICU. Smaller facilities may have a PICU, while larger facilities may offer both a PICU and a Neonatal ICU.

SICU

SICU, or surgical ICU, is where critically ill patients who are in need of surgery or recovering from surgery are sent for care.  These patients may be too unstable to be treated on a regular nursing floor, or ICU level monitoring may be protocol for a particular procedure.  

MICU

Medical ICU, or MICU, is where patients who are critically ill with a medical problem are treated.  This would include patients who are being treated for chronic diseases, such as COPD and diabetes, or patients who are acutely ill, such as patients who developed a serious infection.

TICU

The trauma ICU is where individuals who have suffered a blunt impact are treated.  Injuries such as those received in serious falls, car crashes and other types of impact related accidents may be treated in this area.

CCU

CCU, or the Coronary/Cardiac Care Unit, is a specialized ICU for cardiac issues.  Patients with heart disease, those who experienced a cardiac event such as a heart attack, or patients who are recovering from open heart surgery may be treated in the CCU.  In some facilities, a separate open heart recovery unit may be utilized for surgical patients.

Open Heart Recovery

An open heart recovery unit is where patients who have heart surgery are treated after the procedure.  These patients do not typically go to the post anesthesia care unit after surgery, instead they are taken to the open heart recovery unit to be monitored.

"Stepdown"

A stepdown unit is an area where an intermediate level of care is provided.  This means the patient does not need intensive care level treatment, but is not stable enough to go to a standard floor. There are many types of stepdown units, ranging from surgical stepdown to cardiac stepdown.  For example, a very sick patient may initially be treated in the surgical intensive care unit.  When they improve, they might receive care in the surgical stepdown unit before being treated “on the floor”.

Oncology/Palliative/Hospice

The oncology unit is where patients with cancer receive care intended to improve or cure their disease.  The oncology unit provides treatment and may use therapies such as radiation and chemotherapy.

A palliative or hospice unit is where end of life care is provided for patients who have a life limiting illness, which may or may not be cancer related.  Hospice and palliative care focuses on providing comfort and quality of life.  In some facilities, oncology and hospice/palliative care may be provided on the same unit. 

“The Floor” or Medical/Surgical

A “floor unit” in a hospital is where stable patients who do not require especially close monitoring are cared for.  On the floor, vital signs may be taken every few hours, rather than the patient being constantly monitored as is done in the critical care areas.  The patient may be able to walk to the bathroom with or without assistance, can usually feed themselves and perform some self care.

Patients on the floor may not be quite well enough to go home, or may need medications that have to administered through an IV.  Some patients may be on the floor to have testing, such as blood tests or imaging tests, or they are getting stronger after an illness and waiting for the care team to determine that they are able to safely return home.

Floor units vary widely by name, they may be referred to by location, such as 7 South, which means the south wing of the 7th floor.  Others may be referred to by specialty, such as orthopedics, meaning that patients with bone issues are being treated in the area. 

Source:

Glossary of Terms. St. Louis Children's Hospital. Accessed January, 2014. http://www.stlouischildrens.org/media-center/media-resources/glossary-terms​

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