Nursing

Madison VA is proud to have two nurse residency programs that provide support for new graduate registered nurses. Learn more about nursing at our facilities and how to apply: 

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

RN Transition to Practice (TTP) Residency Program

This clinically intensive paid internship provides opportunities for outstanding students 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 (VA-STEP) formerly known as the VALOR Program

Student Nurse Technician

We have 651 RNS, 69 NPs/CNS's, 9 CRNA's and 72 LPNs serving across our hospital and clinic areas. 

The Community Living Center at the Madison, WI VA is a 14 bed multi-service 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 1B at the Madison, WI VA is a 12 bed multi-service 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 consist of 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; coordinating care of all patients.

2B is a locked 15 bed, acute and therapeutic psychiatric unit. We are unique in that we treat a varied and wide range of psychiatric cases, including complex medical-psychiatric cases. Diagnosis includes, but are not limited to: Bipolar Disorder, Acute Psychosis, Delusional Disorders, Personality Disorders, suicidal ideations, and multiple types of detox from varied substances.

3B is a newly remodeled, 16 bed medical-surgical unit inpatient unit that provides care to a variety of patients. The unit specializing in medical, surgical, oncology, and geriatric nursing and has the capability of cardiac and respiratory monitoring. The available beds are generally full on any given day and the patients stay an average of 3.5 days. Typical staffing is 3 nurses and 2 nursing assistants on the night shift, 6 nurses and 3 nursing assistants on day shift, and 6 nurses and 2 nursing assistants on PM shift. 3B exemplifies strong teamwork among nursing staff while working closely with the interdisciplinary team. 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 for the Veterans we serve.

4A is a 16-bed cardiac/transplant/step-down medical-surgical unit at the Wm. S. Middleton VA hospital. It houses the telemetry monitoring station for the 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 & Peripheral Vascular). 4A has intermediate critical care/step down beds. 4A takes 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 PM shift. Telemetry technicians can monitor up to twenty-four patients at the Madison VA and six patients remotely at the Tomah VA. Telemetry is monitored by 1 technician and 1 RN 24/7.

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. This unit also houses the Epilepsy Center of Excellence, having three beds that can do continuous EEG monitoring on neurology patients. 7B is a fast past unit with the average length of stay being 2.9 days. Staffing rations are 2 NAs on NOC, 3-4 NAs on DAYs, and 2-3 NAs on PMs. Nursing assistants work directly with nurses and Veterans, assisting with activities of daily living. 7B encourages self-growth by offering a multitude of both unit-wide and hospital-wide opportunities. 7B is known for its teamwork and collaboration, with the central focus being the Veteran.

The ICU (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 the specialty surgical teams. Nurses provide full coverage for procedures in rooms. Including but not limited to: Bronchoscopies, Endo/Colonoscopies, tracheostomies, para/thoracentesis, EBUS, central line placements, surgical wound debridement, and swan-ganz placement. As well as manage and provide care for patients on EKOS, Post Arrest Hypothermia, CVVH, 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 and is open 24 hours a day, seven days a week with an average annual census of 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 of the department are to provide a clinical environment conducive to medical screening evaluation and identification of emergency medical conditions, prioritization (triage) for treatment, appropriate and prioritized medical interventions with continued monitoring with the identified medical conditions and evaluation of response to treatment. Other objectives of the ED are to provide necessary definitive medical care to stabilize an emergency medical condition within the discretion of the physician providing the medical screening examination and within the capabilities and capacity of this hospital and to provide for appropriate continuity in patient care through discharge instructions, pertinent referrals, and mechanisms for inpatient admission or transfer to another facility for diagnosis or treatment as indicated.

Specialty Nurse Case Managers work with the Specialty Services to develop and implement comprehensive patient care for the adult/geriatric patient population assessing, planning, implementing, and evaluating activities and programs. Specialty Services at William S Middleton Memorial Veterans Hospital, Madison include: Allergy, Cardiac Surgery, Cardiology, Dermatology, ENT, Epilepsy, Ophthalmology, Diabetes/Endocrine, GI, General Surgery, Hematology, Infectious Disease, Interventional Radiology, MS/Neurology, Neuro Stroke, Neuro Surgery, Oncology, Orthopedics, Palliative Care, Pain, Plastics, Podiatry, Pulmonary, PVS, Renal, Rheumatology, SCI, TBI, Thoracic Surgery, Urology.

Specialty Outpatient Services at William S Middleton Memorial Veterans Hospital, Madison include: Allergy, Cardiac Surgery, Cardiology, Dermatology, ENT, Epilepsy, Ophthalmology, Diabetes/Endocrine, GI, General Surgery, Hematology, Infectious Disease, Interventional Radiology, MS/Neurology, Neuro Stroke, Neuro Surgery, Oncology, Orthopedics, Palliative Care, Pain, Plastics, Podiatry, Pulmonary, PVS, Renal, Rheumatology, SCI, TBI, Thoracic Surgery, Urology. LPNs and Nursing Assistants in these clinics provide direct care to patients including checking in for appointments, vital signs, preparing for procedures, performing EKGs, working closely with the specialty providers throughout the Veteran’s outpatient visit.

The Clinical Contact Center, Triage, is a 24 hour a day, 7 day a week service for Veterans. The Triage Call Center answers calls from Veterans within the Veterans Integrated Service Network (VISN) area 12. Within this area there are 8 hospitals and 40 associated clinics that we are responsible for assisting with. Registered Nurses, Medical Support Assistants and Licensed Independent Providers work collaboratively to provide care to Veterans over the phone and through Video. Nurses triage Veterans over the phone using approved algorithms and nursing assessment. They work collaboratively with the Veteran to determine a plan of care.

• Awarded by Veterans Health Administration as the Overall Best in Patient Experience for 2021
• Recognized by the Association of periOperative Registered Nurses as CNOR Strong – Greater than 50% of our Operating 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 as the Associate Director of Patient Care Services (ADPCS)/Nurse Executive. 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?

The VA has so many great opportunities for Nurses to pursue their passions and interests. I started my career at the VA in 2007 as the MRSA Coordinator and rolled out the MRSA screening process throughout the facility. I then had the distinct pleasure of being the Nurse Manager of a medical surgical unit from 2007 thru 2011. Then, 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, Telephone Care Center now known as the Clinical Contact Center, Mental Health and Speech and Audiology. While in this position I was detailed to the ADPCS at North Chicago/FHCC Lovell for which I was later selected for the position and served there until August 2020. It was an honor to not only serve the Veterans but to serve the Navy recruits and active-duty service members as well. 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. And on March 1st, 2021, I started in my current position as the ADPCS/Nurse Executive.  So, as you can see, from the experiences that I have been fortunate to have served in throughout my career, the VA offers many opportunities to “Love What You Do”.

I would also like to share with you my “Why”.  Why I am committed to providing exceptional Nursing care to our Veterans. My father served in the Navy during WWII as a gunner on the SS Fort Lee. He spoke very little of his service as he suffered from Battle Fatigue now know to us as PTSD. During one of his deployments his ship was torpedoed and sank into the Indian Ocean. He lost many of his friends including two (brothers) 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 happened upon them and 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 really knew very little of his journey until an Australian historian contacted us for information for the book he was writing. The book has been such a blessing to my sisters and I, 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 am proud to be called a VA Nurse.

So come join the VA and Love what you do!

- Teresa Edgren, MSN, RN