JOB TITLE: Registered Nurse

DEPARTMENT: Critical Care Services

REPORTS TO: Director of Acute Care/Critical Care

NIGHT SHIFT - ADDITIONAL $3.00/HOUR SHIFT DIFFERENTIAL

JOB SUMMARY

Provides nursing care to critical medical, surgical and traumatized patients. Supports the patient and family in the dying process. Performs an admission assessment and subsequent assessments. Completes required documentation. Address’ the patients learning ability and needs. Develops a care plan. Enter orders by computer and participates in the daily operation of the Critical Care Unit. Attends required in-service, yearly education day and mandatory departmental meetings. Participates in the collection of data for QI. Adheres to hospital and departmental policies. Practices good communication between departments, with physicians, each other and the department manager. The staff member must be able to demonstrate the knowledge and skills necessary to provide care appropriate to the age of the patients served on his or her assigned unit. The individual must demonstrate knowledge of the principles of growth and development over the life span and possess the ability to assess data reflective of the patient's status and interpret the appropriate information needed to identify each patient's requirements relative to his or her age-specific needs, and to provide the care needed as described in the unit's/area's/department's policies and procedures.

JOB REQUIREMENTS

Current or temporary Wyoming Registered Nurse license. Bachelor of Science in Nursing preferred.

EXPERIENCE

Minimum of one year (two to three preferred) Critical Care and/or Emergency Nursing experience or three years of clinical nursing in a medical or surgical unit or a combined medical/surgical unit, and a course in hemodynamic monitoring that includes both class work and clinical experience.

SKILLS

Knowledge of medical, surgical, and Critical Care Unit nursing principles and the nursing process. Knowledge of aseptic technique and infection control principles. Able to perform effectively in stressful situations. Must be well motivated, organized and able to prioritize multiple tasks. Must be able to interact effectively with a wide variety of people, demonstrating excellent communication skills. Able to serve as an example to other employees. Ability to define problems, collect data, establish facts and draw conclusions.

REQUIRED CERTIFICATIONS

BLS, ACLS, PALS certifications. Encouraged to attain specialty certification for critical care nursing.

ESSENTIAL FUNCTIONS

Nursing Practice

• Complete a head to toe physical assessment and a social assessment of the patient upon admission.
• Develop a written Care Plan upon admission and review and update it daily.
• Initiate cardiac monitoring, oxygen therapy, non-invasive blood pressure, and oximetry. Start/or evaluate IV site. Evaluate existing drainage systems in place.
• Perform delivery of nursing care via the nursing process: assessment (collection of data), problem identification (nursing diagnosis), planning, nursing interventions and evaluation and updating of planning.
• Re-assess patient to identify progress and trends that require intervention or reporting to the physician.
• Assist patient, physician and peers in determining long and short-range goals for patient and formulating a plan to work toward those goals.
• Recognize cardiac arrhythmias. Monitor telemetry on the Acute Care and Critical Care Units. Intervene using physician orders, ACLS Algorithm, or Critical Care standing orders. Post monitor strips per policy.
• Operate and manage equipment including the following: IV pump, PCA pump, feeding pump, cardiac monitors (both room and central), pacemakers, ventilators, CPAP and Bi-PAP machines, pressure modules, arterial lines, cooling/warming units, defibrillators, Doppler, and temperature probes.
• Provide routine patient care. Perform blood draw from arterial and central lines. Interpret computerized monitor trends.
• Administer medications, calculate doses and maintain current knowledge of medications, including intravenous drips.
• Carry out and document medical and nursing treatment, nursing care, interventions and outcomes in a timely and accurate manner.
• Completes documentation necessary for transition between statuses.
• Maintain knowledge of the patient's status during hospitalization and work with health care team to adjust and improve approach to recovery. Utilizes critical thinking skills for appropriate patient interventions.
• Assist physicians in care of the patients. Makes rounds, assists with procedures, provides progress reports on patient status, and assures that orders are carried out.
• Follow procedure for medication administration and narcotics control. Utilizes EMAR, scans and uses 2 sources of patient ID before all medications and procedures.
• Assume professional responsibility for assuring patient care is of the highest standards possible. Communicate questions about appropriateness of medical or nursing care through chain of command, as needed, utilizing the SBAR form of communication.
• Ensures that consents are obtained when needed, and that all records are signed and legally complete. Ensure completion of time out procedures as appropriate.
• Complete incident and error forms when appropriate.
• Assess patient’s learning needs. Educate the patient and family.
• Treat patients and their families with respect and dignity.
• Practice within Nursing Standards of Practice and follow standards of patient care & CRH Policies and Procedures. Adheres to MD orders.

Unit and Hospital Involvement

• Supervise non-professional staff, CNAs, LPNs, and Secondary Critical Care RNs in the delivery of care to assigned patients. Assist with priority setting, act as a resource personnel for less experienced staff.
• Follow procedures to ensure that supply and medication stocks are rotated and replaced as used. Participate in monthly outdating of medications and supplies, checking of crash cart, hemodynamic cart, chest tube cart, and trach box. Check, order and stock supplies according to par level.
• Adhere to standards of safety and infection control in delivery of patient care. Follow the standard for infection control: hand washing, protective eyewear, mask, gown, gloves, head cover, and shoe cover, as appropriate. Proper disposal of contaminated items and the use of isolation.
• Exhibit cooperation and a positive attitude toward other hospital departments, including coordinating smooth transfer of patients for procedures or diagnostic test. Maintain a positive attitude toward managers, physicians, co-workers, patients and visitors. Behave in a professional manner, and maintain good interpersonal relationships with other staff, departments, managers, and physicians.
• Participate in in-service programs as both student and teacher. Take primary responsibility for keeping own knowledge and skills current.
• Maintain confidentiality.
• Enforce and adhere to all hospital-wide policies and unit protocols.
• Assist with collection of data for process and quality improvement, and to meet unit goals.
• Attend mandatory annual education, monthly staff meetings, and in-service.
• Initiate and coordinate Code Blue responses.
• Participate in orientation of new Critical Care Unit staff. Provide nursing students with opportunities to observe and learn.
• Assist with collection of data for process and quality improvement, and to meet unit goals.
• Assist nursing staff in other departments as requested and qualified when need arises.
• Perform other related duties as assigned or requested.