Position Summary: Provides direct and indirect patient care in the Emergency Department (ED). The RN will coordinate planning with other disciplines in the hospital. The RN will provide care that meets the psychosocial, physical, and general aspects of patient care. She or he will provide care that reflects initiative, flexibility, and responsibility indicative of professional expectation with a minimum of supervision. Determines priorities of care based on physical and psychosocial needs of patients, as well as factors influencing patient flow through the system. The RN is able to triage patients safely, rapidly, and accurately, every patient that enters the emergency care system. He or she will communicate with Emergency Department physicians and/or the Primary Care Physicians (PCP's) about changes in patient's status, symptomatology, and results of diagnostic studies. The RN is able to respond quickly and accurately to changes in condition or response to treatment. The nurse will participate in continuing education and professional development activities as required by the department and to maintain current nursing license. This is a SAFETY SENSITIVE POSITION.
*See the Arkansas State Board of Nursing for the RN scope of practice.
Demonstrates Competency in the Following Areas:
- Receive report before giving care. Narcotic count every shift by LPN or RN along with LPN or RN from previous shift. Assess patient conditions/needs and staff skills. Assign and delegate duties appropriately.
- Assess need for supervision of LPN's, Patient Reps, Ward Clerks, CNA's, and new staff.
- Provides direct patient care, evaluates outcomes, consults with other specialists as required and adjusts nursing care processes as indicated to ensure optimal patient care.
- Ability to perform a head-to-toe assessment on all patients and reassessments as per policy. Makes initial rounds on patients that are currently in department at beginning of shift after report. This includes neonate, pediatric, adolescent, and geriatric patients and the general patient population.
- Uses triage process to ensure timely and appropriate care to patients. Accurately assigns triage categories. Completes initial head to toe assessment on all patients that present to ED or admissions to MCU.
- Check medical record for physician orders and results of diagnostic studies.
- Ability to adequately assess and reassess pain. Utilizes appropriate pain management techniques. Educates the patient and family regarding pain management.
- Ability to monitor hemodynamic status of patient and correctly interpret the results.
- Demonstrates knowledge of cardiac monitoring and can identify dysrhythmias and treat appropriately.
- Performs nursing skills according to skills check list and return demonstration(s). Will learn the NIHSS Stroke Scale and be able to demonstrate it adequately along with operating the telemedicine. Maintains current knowledge of medications and their correct administration based on age of the patient and his/her clinical condition. Reviews patient orders, lab results, vital signs, and condition of patient prior to administration of medications.
- Follows the five (5) medication rights and reduces the potential for medication errors.
- Prepares, hangs, monitors, and discontinues IV fluids.
- Maintains accurate and continued nursing documentation including patient histories, conditions, treatments, responses, and assessment of changes. This includes the Medication Reconciliation Form (Med Rec) on all patients that come to the ED. Will update each time the patient presents to the ED to verify that the Med Rec is current.
- Performs all aspects of patient care in an environment that optimizes patient safety and reduces the likelihood of medical/health care errors.
- Treats patients and their families with respect and dignity. Identifies and addresses psychosocial, cultural, ethnic, and religious/spiritual needs of patients and their families.
- Functions as liaison between administration, patients, physicians and other healthcare providers.
- Demonstrates knowledge of the principles of growth and development over the life span and the skills necessary to provide age appropriate care to the patients served. Able to interpret data about the patient's status in order to identify each patient's age specific needs and provide care needed by the patient group.
- Interacts professionally with the patient and family and involves patient and family in the formation of the plan of care.
- Formulates a teaching plan based on identified learning needs and evaluates effectiveness of learning; includes family in teaching, as appropriate.
- Maintains established departmental policies and procedures, objectives, performance improvement program, safety, environmental and infection control standards.
- Maintains a safe, comfortable, and therapeutic environment for patients and families in accordance with hospital standards.
- Assists in cost containment through appropriate ordering and conserving of supplies and equipment.
- Cooperates with other personnel to achieve departmental objectives; maintains good employee relations and interdepartmental objectives.
- Responds promptly to changes in workload, adjusting assignments as necessary to achieve optimal productivity and efficiency.
- Provides resource information to other staff.
- Demonstrates the ability to assist physicians with procedures in the ED.
- Supervises temporary employees and employees who do not supervise; allocates and monitors the work of others; leads one or more employees performing similar work.
- Assists in orientating new employees to the ED.
- Assists the ED nurse manager in the development, implementation, and evaluation of performance improvement indicators to improve patient outcomes and the work environment.
- Participates in problem solving with other healthcare team members related to management of clinical care area.
- Enhances professional growth and development through participation in educational programs, current literature, in-service meetings, and workshops; shows responsibility for own professional practice and ongoing education.
- Works at maintaining a good rapport and a cooperative working relationship with physicians, staff, and other health care team members.
- Ensures an adequate stock of supplies in ED and MCU and orders as needed. Pulls out of date stock and replenishes in each department. Ensures proper functioning of equipment and documents this on shift check-lists.
- Medical and surgical asepsis is carried out during treatments and special procedures.
- Demonstrates the ability to be flexible, organized and function under stressful situations.
- Responds to all codes within the hospital as indicated according to procedure.
- Listen and initiate feed-back to ensure effective communication. Use constructive feed-back to improve performance. Resolve problems with interpersonal relationships, referring them by appropriate chain of command when necessary.
- Practice discretion in information shared with patients and peers. Maintain information released according to HIPAA Guidelines. If unsure talk with HIPAA Compliance Officer. Avoid excessive noise and protect patient privacy.
- Address people by name. Identify yourself on the telephone by name, title, and department. Use appropriate phone etiquette.
- Express frustrations in appropriate time, manner, and location.
- Support other staff in the performance of their duties. Respond promptly to request from supervisor, peers, and other employees. Communicate criticism in constructive, private manner. Accept constructive criticism in appropriate manner. Praise peers on quality job performance.
- Performs other related duties as assigned or requested.
Planning and Organization:
- Pre-plan nursing care to perform in an organized manner in caring for groups of patients.
- Obtain materials and supplies needed for patient care.
- Use resource materials as necessary to include nursing policy and procedure books and manuals from other departments.
- Utilize time effectively and productively.
- Identify nursing diagnosis; initiate and update individualized nursing care plans.
- Involve patient/family in the planning of care and in establishing goals.
- Organize work according to priorities.
- Maintain Medact as indicated.
- Plan for oncoming shift needs.
Professional Requirements:
- Adheres to dress code, appearance is neat and clean.
- Completes annual/bi-annual education requirements.
- Maintains regulatory requirements.
- Maintains patient confidentiality at all times.
- Reports to work on time and as scheduled, completes work within designated time.
- Wears identification while on duty, uses computerized punch time system correctly.
- Completes in-services and returns in a timely fashion.
- Attends annual review and department in-services, as scheduled.
- Attends at least 10 staff meetings annually, reads and returns all monthly staff meeting minutes.
- Represents Bradley County Medical Center in a positive and professional manner in the community.
- Actively participates in performance improvement and continuous quality improvement (CQI) activities.
- Complies with all organizational policies regarding ethical business practices.
- Communicates the mission, ethics, and goals of the facility.
Regulatory Requirements:
- Graduate of an accredited school of nursing with critical care or emergency nursing experience.
- Current Registered Nurse license in the state of Arkansas and maintains this license by renewing every two (2) years.
- Experience as Charge Nurse or other leadership role.
- Current BLS certification and will continue to renew bi-annually.
- Current ACLS certification and/or be in the process of renewing this certification within 90 days of hire date. The nurse will continue to renew bi-annually.
- NIHSS Stroke Scale certification obtained within 30 days of hire. Will renew annually.
- TNCC within one (1) year of hire.
Language Skills:
- Ability to communicate effectively in English, both verbally and in writing.
- Additional languages a plus, but not required of position.
Physical Demands:
- Must be able to lift and restrain patients when necessary.
- Must have full use of arms, legs, fingers, and hands and be comfortable standing, walking, bending, and kneeling while on an 8-hour or 12-hour shift.
- Must be strong enough to push and pull heavy equipment as needed.
- Must be able to assist patients with walking or using the bathroom and helping patients in and out of bed, chair, wheelchair, or stretcher.
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