Surgical Stepdown

Welcome to the Surgical Stepdown!

We are a critical care unit that specializes in the care of postoperative surgical patients —from thoracic, oncology-endocrine and emergency general surgery to head & neck, gynecological, and trauma surgery. The patients admitted to the surgical stepdown unit generally sicker and require more frequent assessments and interventions than can be provided in the general acute-care setting to include cardiac monitoring and continuous pulse-oximetry. Patients are usually assigned to this unit because they have a significant history, or it was determined that they needed to be more closely monitored. The patient ratio is lower on this unit which allows for more frequent interaction and intervention with patients, typically three to four patients per nurse. We’re looking for nurses who are compassionate, self-motivated and dedicated to providing the best care possible for patients. I began my career at Vanderbilt as a care partner on this unit, and I have been fortunate to work with many of the staff here during my 18 years. While on paper there is a vertical hierarchy in the command structure, I feel it’s more of a horizontal working relationship with the Shared Governance structure as we all work together to provide the best possible care to our patients. The success of our unit is definitely a collaborative effort, and there’s a high level of trust within our workgroup. If you’d like to learn about multiple specialties and expand your clinical skills, apply now and join us!

Aaron Hirsch, MSN, RN
Urology Surgery (9S), Surgical Stepdown (9N)


Location Location
Ninth floor of Vanderbilt University Hospital
Nurse to Patient Ration Nurse to Patient Ratio
1:3 or 1:4
Number of Beds
Focus of Care Patient Profile
Adult post-operative patients in thoracic, emergency general surgery
and trauma surgery as well as oncology services.    
Unit Team Staff Mix
•    Registered Nurses
•    Care Partners
Certifications Required Certifications
•    RN Licensure
•    BLS
Shift Rotations Rotation/Shifts
•    12 hour shifts, 36 hour week
•    Modified self-scheduling 
•    Team schedules holidays
Nurse Residency Program Our unit is part of VUMC's Nurse Residency Program
Nursing Careers at Vanderbilt


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“I have worked in this unit for nearly 11 years, and during that time, I’ve served as a staff nurse, staff leader and patient flow nurse. I have been fortunate to be able to fulfill these roles thanks to our management team always encouraging us to advance and try new career opportunities. Caring for patients from such a diverse range of surgical services keeps you interested and always learning new things.”

Tanya A., RN
9N Surgical Stepdown