Skills required include post-op care, orthopedic experience, TPN/PPN management, stroke assessment/NIH scale, chest tube management, PIV starts, trach care, cardiac rhythm interpretation, NGT placement, drain/tube management (Dobhoff, PEG, Hemovac, JP drains, flexiseals, foley), PCA pump management, and wound care. Support staff includes CNAs for all scope duties, HUC/receptionist on dayshift only, phlebotomy, IV/VAT team on dayshift only, resource nurse as staffing allows, and 24/7 RT, hospitalist, and intensivist coverage.