Under the supervision of the Emergency Department Manager, the primary function of the Emergency Room Registered Nurse is to triage patients that present to the Emergency Department, coordinate a timely medical screening exam by Emergency Medical Provider and render medical care as ordered by the Emergency Medical Provider. The Emergency Room Registered Nurse position will involve the assessment, diagnosis, treatment and evaluation of perceived, actual or potential, sudden or urgent, physical or psychosocial problems that are primarily episodic in nature and that occur in a variety of settings. These may require minimal care or advanced life support measures, patient and significant other education, appropriate referral and knowledge of legal implications. The Emergency Room Registered Nurse will care for people of all ages with undiagnosed, diagnosed and misdiagnosed problems of varying complexity.

The Emergency Room Registered Nurse secondary functions will include assisting in keeping the Emergency Department stocked, interviewing patients (or representative) to obtain personal, statistical and financial information and to work with the Emergency Department Coordinator to develop, implement policies and procedures. The Emergency Room Registered Nurse is also responsible for maintaining unit organization, cleanliness and contributing to the efficient use of available resources.

The Emergency Room Registered Nurse has frequent contact with the public and handles sensitive information regarding the patient and hospital business and must maintain confidentiality of that information. He/she must act as an ambassador of public relations for the hospital and the community including patients, families, visitors and other organizations.

Other responsibilities may be assigned or delegated by the Emergency Department Coordinator or Director of Patient Care Services.

SPECIFICATIONS

· Performs symptoms analysis of chief complaint on all patients entering the Emergency Department collecting subjective and objective data.

· Institutes and maintains Emergency Department Record and Registry Log on all patients entering the department.

· Ensures that all patients are triaged upon arrival and appropriate level of care instituted from findings.

· Coordinates timely medical screening exam by Emergency Medical Provider.

· Able to differentiate severity of patient complaint and prioritize care.

· Assigns patient to appropriate care area based on triage findings which facilitates patient flow through the Emergency Department.

· Initiates treatment measures appropriately.

· Communicates triage/assessment findings clearly, concisely and in a timely manner to appropriate MD.

· Initiates diagnostics as ordered.

· Communicates pertinent information to family or significant other when appropriate.

· Mobilizes additional personnel when appropriate.

PLANNING

· Worked performed to predetermine the course of action to obtain quality patient care.

· Effectively manages use of physical resources based on triage classification and continuing patient assessment.

· Ensures that supplies and equipment necessary for emergency care are readily available at all times.

· Implements safety procedures for each patient in accordance with that patient’s specific needs.

· Plans for effective interdepartmental communications.

· Plans for need of special equipment and supplies needed for specific procedures.

INTERVENTION:

· Performs independent monitoring of patients.

· Independently performs lifesaving, limb saving measures within the scope of professional nursing practice.

· Charts appropriately on the EMR.

· Appropriately scans patients and medications when administering medications, and Documents accordingly on the EMAR.

· Communicates changes in patient’s condition immediately to appropriate care provider.

PROFESSIONAL ACCOUNTABILITY:

· Evaluates treatments given and documents response of patient.

· Notifies care provider of untoward responses to treatments given.

· Adheres to departmental hospital policies and procedures.

· Follows guidelines for obtaining permission to treat for minors or unconscious persons.

· Emergency Room nurse exercises authority consistent with the role and responsibility in accordance with the nursing practice act.

· The Emergency Department nurse assumes responsibility and accountability for individual nursing judgments and actions.

· Serves as a professional role model.

· Safeguards patient’s right to privacy by judiciously protecting confidential information.

· Emergency Department nurse is able to remain calm and perform necessary duties during challenging and stressful situations.

· Participates in unit activities.

· Participates in departmental and intradepartmental problem solving.

CONTINUING EDUCATION:

· Record on file in HR. Each individual is responsible for keeping file current and updated on needed Education and CEU’s.

· Attendance may be required at departmental staff meetings to formulate needed changes in procedures and work schedules. Make suggestions, constructive criticism and personal requests in a non-abrasive manner.

· Read and initial memos and administrative directives as posted.

· Maintain a well-stocked and clean department by cleaning equipment and replacing supplies before leaving the unit.

PERFORMANCE STANDARDS

• Plans work assignment to meet the needs of the patients and peers.
• Plans for effective communications in the Acute Care area and other hospital departments.
• Plans for administration of policies and procedures.
• Forecasts need for special equipment and supplies for specific procedures coordinating activity with Acute Care supervisor.
• Utilizes knowledge of skills in medical, surgical, and pediatric procedures as a basis for implementing patient care.
• Coordinates daily patient care with staff and physicians.
• Organizes own time effectively.
• Identifies patient, physician and staff needs and sets priorities accordingly by communicating with all involved personnel.
• Adheres to standards of care, department objectives and individual objectives.
• Follows the hospital and nursing department policies and procedures.
• Identifies deficiencies in patient care and initiates corrective action.
• Participates on appropriate committees.
• If team leading, an LPN, will complete the RN/LPN chart review in the EMR System
• Communicates effectively with nursing staff, physicians, and other hospital staff.
• Communicate anticipated and critical changes in patient care to supervisor and to physician.
• Serves as a professional role model.
• Participates in the administering and assessment of nursing care.
• Participates in activities to identify and meet patient needs.
• Participates in unit activities.
• Identifies and participates in activities to maintain self-motivation.
• Regular attendance at general in service programs, unit in service and other educational experiences.
• Develops skills for effective delegation of responsibilities in working as a team
• Participates in goal setting for self and department.
• Recommends activities to the Acute Care Supervisor that will benefit the nursing staff in general.
• Nursing assessment is obtained and completed within 2 hours of admission.
• Psychosocial needs and perception of patient and/or family expectations of present hospitalization are identified and documented.
• Appropriate teaching given and documented.
• Alertness and skill in recognizing and identifying symptoms. Symptoms are recognized and appropriate action taken (ex: notify physician if patient has unrelieved pain from medication ordered, offer prn medications, etc.).
• Set priorities and give care based on problem solving needs. Ability to complete work within scheduled time.
• Take responsibility for such activities and follows hospital policy and procedure for the following:

-Giving medications following procedure

-Blood Transfusions

-IV Meds

-IV Fluids

-Starting IV’s

-Special treatments (i.e. respiratory, dressing changes, ect)

-Providing bedside nursing care

-Serving trays

-Answering lights and telephones

-Admitting, transferring and discharging patients

-Maintaining supplies and equipment

-Appropriate patient teaching concerning routine hospital procedures and

special procedures regarding their condition

-Being familiar with basic cardiac rhythms, emergency drugs and equipment

-Complete charting each shift

-Performing or appropriately delegating ADL’s for patient

-Assisting physician with procedures such as chest tube placement,

paracentesis thoracentesis, suturing of wounds etc.

-Understands basics of post-partum and nursery care

-Does appropriate discharge teaching including activity instructions,

medication instructions, among others

-Accurate documentation

-Knowledge of procedures of handling the deceased

• Take responsibility for such activities and follows hospital policy and procedure for the following:

-Understands and is able to explain advanced directives to patients when

Requested

• Interacts with other team members to keep them informed of any changes in patients condition
• Check narcotics with each shift change or as procedure dictates
• Participate in teaching and orienting co-workers within the unit. Own performance sets desired example.
• Participation and documentation of continuing education.
• Appropriate areas of the medical record.
• Plan work assignment to meet needs of the patients and peers.
• Keep the primary physician informed of patient’s condition and any acute changes.

GENERAL RESPONSIBILITIES

1. Reports for scheduled shift on time and prepared to assume responsibilities.

• Reports to work in proper uniform or attire.
• Leaves for meal break on time and returns on time.
• Varies work schedule to meet the needs of the department.
• Ensures the department head prior to working has approved all overtime.
• Schedules all time off with supervisor’s approval.
• Strictly adheres to hospital attendance/tardiness policies 100% of the time.
• Performs all duties as assigned.
• Wears I.D. badge in a visible location at all times on hospital property.

2. Attends and participates in meetings and is responsible for information communicated at meetings.

• Attends all mandatory in service on a timely basis as scheduled.
• Participates as an active team member at staffs meetings.
• Reads communications and acts upon in a positive and informative manner.

3. Assists all patients, family members, physicians, visitors, and employees in a professional and courteous manner.

• Extends special attention and sensitivity to all patients, visitors, physicians, and fellow employees.
• Assists in maintaining an atmosphere of cooperation with other departments and allied professionals.
• Demonstrates respect and cooperation in all staff relationships, and a genuine willingness to prevent or resolve inter-personal conflicts.
• Demonstrates the ability to participate in and/or implement team decisions.
• Actively participates in and encourages actions that promote good public relations with patients’ families, visitors, and the community.
• Works together in a spirit of teamwork.
• Shares information on a “need to know” basis.

4. Follows Infection Control procedures at all times.

• Clinical Personnel: Strictly adheres to standard precautions by adhering to the usage of personal protective equipment when handling blood or body fluids.
• Non-Clinical Personnel: Washes hands and other skin surfaces with soap and water thoroughly and often in an effort to control spreading of germs within the department and facility.
• Adheres to isolation procedures at all times as applicable.

5. Adheres to the following environmental care standards.

• Demonstrates adequate knowledge of safety policies and procedures, the use of MSDS sheets, hazardous material procedures, and safety codes.
• Code Blue, Code Gray, Code Silver, Code Amber, Code Red, Code Orange, Rapid Response Team
• Demonstrates adequate knowledge of security issues, i.e. personal protection, protection of personal and hospital property.

6. Be familiar with the collective bargaining agreement of the USNU and Mid-Valley Hospital.

7. Demonstrates the ability to adapt to varied age-specific patient populations.

• Non-Clinical Personnel: This position has no responsibility for the assessment, treatment, or care of patients. However, the ability to communicate and interact with patients of all ages is required.

EDUCATION: Graduated from an accredited School of Nursing.

EXPERIENCE: The Emergency Department will employ only registered nurses who meet the requirements of a staff nurse at Mid-Valley Hospital plus the special qualifications necessary to render quality emergency care. She/he must demonstrate professional behavior.

REQUIRED CERTIFICATION/LICENSURE/REGISTRATION: Current state nursing licensure. ACLS is required upon hire with biannual renewal, CPR annually, TNCC at 4 years and PALS trained.

OTHER QUALIFICATIONS: Ability to communicate clearly and effectively: delegate and coordinate through leadership skills. She/he must demonstrate professional behavior. She/he must participate in continuing education and demonstrate motivation for continued self-improvement. Ability to communicate with people of diverse backgrounds and educational levels; i.e. patients, families, employees, physicians, etc.

CAREER PATH: Nursing Supervisor

PERSONAL PROTECTIVE EQUIPMENT: Standard precautions.

PHYSICAL REQUIREMENTS

May be required to work any shift in emergencies.

May be required to work any day of the week.

Exerting up to 50 pounds of force occasionally, and/or up to 25 pounds of force frequently, and/or up to 10 pounds of force constantly to move objects.

WORKING CONDITIONS

Works in the Emergency Department which encompasses a variety of kinds of patients (i.e., pediatric, psychiatric, geriatric, orthopedic, medical, surgical, detox and cardiac patients). Occasional stress during emergency situations. Majority of work is performed indoors. High risk for biohazards.

This person spends 95% of their time in temperature controlled space. The potential for exposure to bio-hazardous agents or exposure to blood-borne pathogens and other potential infectious agents is high. This position requires contact with patients and staff under a wide variety of circumstances. This person is subject to varying and unpredictable situations, many interruptions, long irregular hours, multiple calls and inquiries.

WAGE AND COMPENSATION

Wage range $ 34.13 hr. - $61.82 hr. - DOE Plus 10% for Per Diem