Since their inception, progressive care units have represented the “step down” from critical care and the “step up” from the general medical-surgical floor. Patients on progressive care units are typically not sick enough to be in an intensive care unit (ICU), but too sick for medical-surgical nurse-to-patient ratios. As a result, progressive care nurses often feel as though they reside in “no-man’s land”—neither a part of the critical care service nor a part of the medical-surgical division.

Traditional organizational charts place progressive care units in the medical-surgical arena, though the 2 care environments are very different. Today, again despite differences, progressive care units are grouped with critical care. What can progressive care nurses do? Where do they go for resources and support? How can they get past the “us versus them” scenario that is all too common between the staffs at various points along the continuum of care?

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