Nursing

We have two nurse residency programs: 

Post-Baccalaureate Registered Nurse Residency (PB-RNR) Program

RN Transition to Practice (TTP) Residency Program

This clinically-intensive, paid internship provides opportunities to develop competencies in clinical nursing while at an approved VA health care facility. Opportunities for learning include didactic classroom and simulation experiences, competency-based clinical practice with a qualified registered nurse preceptor and participation in nursing-focused clinical conferences.

VA Student Trainee Experience Program 

Student Nurse Technician

We have approximately 651 RNs, 69 NPs/CNS's, 9 CRNA's and 72 LPNs serving our hospital and clinics. 

Our Community Living Center is a 14-bed, multiservice unit, which includes post-acute and rehabilitation with a specialty in hospice and palliative care. Medical conditions include cancer, diabetes, dementia, alcohol abuse with cirrhosis, respiratory, cardiac, digestive, wound care, renal and hematologic disorders. Many patients have multiple diagnoses and/or sensory impairments with acute and rehabilitation needs. Nursing care is provided on a 24- hour basis by registered nurses and nursing assistants. The nursing process of assessment, planning, implementation and evaluation is applied in an ongoing, systematic manner to all patients.

The General Medical/Surgical Unit known as unit 1B is a 12-bed, multiservice unit, which includes primarily medical patients and specializes in care of Veterans with dementia. Medical conditions include cancer, diabetes, dementia, alcohol abuse with cirrhosis, respiratory, cardiac, digestive, renal and hematologic disorders. Many patients have multiple diagnoses and/or sensory impairments with acute and rehabilitation needs. Nursing care is provided on a 24-hour basis by registered nurses and nursing assistants. The nursing process of assessment, planning, implementation and evaluation is applied in an ongoing, systematic manner to all patients. Nursing personnel are intricately involved in development, implementation and evaluation of interdisciplinary care. This requires nursing staff to participate with an interdisciplinary approach in meeting Veteran health care needs, which includes being an active participant in interdisciplinary rounds. Rounds with the entire interdisciplinary team consisting of physicians, nurse practitioners, nutrition service/dietitian, physical therapy, occupational therapy, social work, pharmacy and other specialty groups as needed.

Unit 2B is a locked, 15-bed, acute and therapeutic psychiatric unit. We treat a wide range of psychiatric cases, including complex medical-psychiatric cases. Diagnosis can include bipolar disorder, acute psychosis, delusional disorders, personality disorders, suicidal ideations and multiple types of detox from varied substances.

Unit 3B is a newly remodeled, 16-bed medical-surgical inpatient unit that provides care to a variety of patients. The unit specializes in medical, surgical, oncology and geriatric nursing and has the capability of cardiac and respiratory monitoring. Beds are generally full and patients stay an average of 3.5 days. Typical staffing is three nurses and two nursing assistants on night shift, six nurses and three nursing assistants on day shift, and six nurses and two nursing assistants on evening shift. Unit 3B provides acute level nursing care and is intricately involved in the interdisciplinary approach in meeting patient needs. This systematic process is applied to all patients with a goal of care to restore the Veteran to maximum function, prevent further decline, maximize independence and/or provide comfort as necessary. Discharge planning is an essential component of our nursing practice and an interdisciplinary approach for teaching and discharge planning assures continuity of care.

Unit 4A is a 16-bed, cardiac/transplant/step-down medical-surgical unit. It houses the telemetry monitoring station for Madison VA and Tomah VA. 4A cares for patients in various stages of the transplant process, cardiac care (NSTEMI, CABG) and post-surgical care (thoracic, cardiac and peripheral vascular). 4A has intermediate critical care/step down beds and receives admissions from the emergency department, clinics, outside facilities and transfers from the intensive care unit. Staffing ratios for nursing assistants are typically 10:1 on night shift, 6-7:1 on day shift and 6-8:1 on the overnight shift. Telemetry technicians can monitor up to 24 patients at Madison VA and six patients remotely at Tomah VA. Telemetry is monitored by one technician and 1 RN 24/7.

Unit 7B is a 21-bed, medical-surgical unit that provides care to a variety of patients. The unit specializes in a number of services, including general surgery, orthopedics, neurology, ENT, plastics and urology. It houses the Epilepsy Center of Excellence with three beds that can do continuous EEG monitoring on neurology patients. 7B is a fast-paced unit with the average length of stay of 2.9 days. Staffing ratios are 2 NAs on night shift, 3-4 NAs on day shift and 2-3 NAs on PM shifts. Nursing assistants work directly with nurses and Veterans, assisting with activities of daily living. 7B encourages self-growth by offering unit-wide and hospital-wide opportunities. 

8B is a 16-bed, mixed surgical and medical intensive care unit. The ICU admits patients for general acute care, intermediate care and critical care. Based on the patient’s admission level and need for skilled care, the typical RN/patient ratios are 1:1 - 1:3. Our staff care for a variety of surgical patients from all specialty surgical teams. Nurses provide full coverage for procedures in rooms, including bronchoscopies, endo/colonoscopies, tracheostomies, para/thoracentesis, endobronchial ultrasound, central line placements, surgical wound debridement and Swan-Ganz placement. Nurses also manage and provide care for patients on catheter-assisted thrombolysis treatment, post arrest hypothermia, continuous veno-venous hemofiltration, balloon pumps and many other high-skilled types of equipment.

The Emergency Department is a 10-bed emergency treatment facility with two additional fast track beds that is open 24 hours a day, seven days a week with approximately 16,000 visits per year. Our patient population comprises of adult male and female Veterans with multiple acute and chronic medical and/or psychiatric/psychosocial conditions. The ED provides medical evaluation, treatment and disposition to presenting patients of various ages and varying levels of illness and injury from minor to critical. Objectives are to provide a clinical environment conducive to medical screening evaluation and identification of emergency medical conditions, prioritization for treatment, appropriate and prioritized medical interventions with continued monitoring of identified medical conditions and evaluation of treatment response. Other objectives are to provide necessary definitive medical care to stabilize an emergency medical condition within the discretion of the physician and to provide continuity of care through discharge instructions, referrals and mechanisms for inpatient admission or transfer to another facility.

Specialty nurse case managers work specialty services to care for adult and geriatric patients by assessing, planning, implementing and evaluating activities and programs. Specialty services include allergy, cardiac surgery, cardiology, dermatology, ENT, epilepsy, ophthalmology, diabetes/endocrine, gastrointestinal, general surgery, hematology, infectious disease, interventional radiology, neurology, neuro stroke, neuro surgery, oncology, orthopedics, palliative care, pain, plastics, podiatry, pulmonary, persistent vegetative state, renal, rheumatology, spinal cord injury, traumatic brain injury, thoracic surgery and urology.

Specialty Outpatient Services include allergy, cardiac surgery, cardiology, dermatology, ENT, epilepsy, ophthalmology, diabetes/endocrine, gastrointestinal, general surgery, hematology, infectious disease, interventional radiology, neurology, neuro stroke, neuro surgery, oncology, orthopedics, palliative care, pain, plastics, podiatry, pulmonary, persistent vegetative state, renal, rheumatology, spinal cord injury, traumatic brain injury, thoracic surgery, urology. LPNs and nursing assistants provide direct care to patients including checking in for appointments, vital signs, preparing for procedures, performing EKGs and working closely with specialty providers throughout Veteran visits.

The Clinical Contact Center provides 24/7 triage services by answering calls from eight regional Veteran hospitals and 40 associated clinics. Registered nurses, medical support assistants and licensed independent providers collaboratively provide care to Veterans over the phone and through video. They work collaboratively with the Veteran to determine a plan of care.

• Recognized by the Association of periOperative Registered Nurses as CNOR Strong – greater than 50% of our nurses are certified nurses in the operating room
• Recognized by the Association of periOperative Registered Nurses with the Go Clear Award- Surgical Smoke-Free Recognition Program
• Recognized by the Institute for Healthcare Improvement as an Age-Friendly Health System
• Recognized as a Dementia Friendly medical center
• Recognized by the American College of Emergency Physicians with an Accredited Geriatric Emergency Department
• Nurse residency programs are accredited from the Commission on Collegiate Nursing Education 
• Nurses are recognized with DAISY Awards for nursing excellence
• Staff that support nurses are recognized with local Bee Awards

It is my distinct honor to serve and represent the outstanding nursing staff at the William S Middleton Memorial Veterans Hospital. I am excited to work with extraordinary nurse leaders, nurses and support staff. Our professional practice model guides our commitment to Veteran-centered care, evidence based practice, shared decision making, interprofessional relationships, professional development and leadership at all levels of nursing.

So, why do I love what I do?

VA has so many great opportunities for nurses to pursue their passions and interests. I started my career at VA in 2007 as the MRSA Coordinator and rolled out the MRSA screening process throughout the facility. I then had the pleasure of being the nurse manager of a medical surgical unit from 2007-2011. In 2011, a unique opportunity was offered to me to open the new Community Living Center (CLC), a short stay rehabilitation, skilled nursing and hospice unit. It was such a privilege to be part of the CLC team and provide another level of care to our Veterans. In 2016, I was selected as the chief of Emergent, Transitional, Speech and Audiology. I thoroughly enjoyed that opportunity to stretch and grow, learning about the ED, Clinical Contact Center, Mental Health and Speech and Audiology. While in this position I was detailed to the associate director for patient care services at Captain James Lovell Federal Health Care Center in Chicago, which I was later selected for and served until August 2020. It was an honor to not only serve the Veterans but to serve the Navy recruits and active duty service members. 

I was excited to return to Madison in August of 2020 to serve in an acting role as the chief of quality improvement prior to starting my position as the chief of emergent, transitional and mental health. The next year I began my current position as associate director of patient care services/nurse executive. 

As you can see, from the experiences that I have been fortunate to have throughout my career, VA offers many opportunities to “Love What You Do.”

I am committed to providing exceptional nursing care to our Veterans. My father served in the Navy during World War II as a gunner on the SS Fort Lee. He spoke very little of his service as he suffered from battle fatigue, now known as PTSD. During one of his deployments, his ship was torpedoed and sank into the Indian Ocean. He lost many friends, including two from his childhood, who were on the same ship. My father survived and was in one of 10 lifeboats full of other survivors for 10 days in the middle of the ocean with no hope of rescue. Miraculously, an Australian merchant marine ship rescued them, taking the survivors into Perth, Australia. 

My father received the Purple Heart for sustaining significant burns while trying to rescue others. My sisters and I knew very little of his journey until an Australian historian contacted us for information for a book he was writing. The book has been such a blessing to us, to finally know more about our dad and his military service. I lost my father at a young age, but I know he would be proud of my VA nursing career and service to the Veterans. My dad, like most of our Veterans, was very proud of his service. 

So that is my “why” I love what I do and the reason I am proud of our exceptional care and to be called a VA nurse.

So come join the VA and love what you do!

- Teresa Edgren, MSN, RN