Registered Nurse Definitive Observation Unit (Healthcare)

JOB SUMMARY:

Responsible for the provision and coordination of patient centered care. The Registered Nurse, RN, coordinates care to achieve desired outcomes, participates in patient and family teaching and provides leadership by delegating and working cooperatively and collaboratively with ancillary, nursing and other patient team members in maintaining standards for professional nursing practice and performance in the clinical setting. The RN must be able to demonstrate knowledge and skills necessary to provide care and service to all patients. Actively and consistently contributes to department operations and communications, behaves in a manner consistent with the mission, vision, and values of Pipeline Health, upholding standards of AIDET (Acknowledge, Introduce, Duration, Explanation, Thank you) patient communication. Essential functions apply to all RN positions along with additional department specific functions as listed.

ESSENTIAL FUNCTIONS:

· Change dressings, insert catheters, and start IVs.

· Accurately obtains & records results of assessment, care delivery, medication and administration, treatments, responses in the electronic medical record or on designation documentation packets.

· Adjust specialized medical equipment as needed, as well as interpret and record measurements.

· Monitor patients' vital signs and report adverse reactions to medication in a timely manner.

· Answer questions and educate patients and families on surgical procedures and post-surgery care.

· Maintain and update patient files, medical charts, and health records.

· Collects current symptoms, detailed patient history and consults and coordinates with healthcare team members to assess, plan, implement & evaluate patient care plans.

· Organize and plan care of patients, with the ability to assess, determine treatment rationale and delivery, follow protocols, administer medications with accuracy and knowledge, educate patients.

· Attends and/or completes monthly, annual, and assigned training.

· Accurately obtains & records results of assessment, care delivery, medication and administration, treatments, responses in the electronic medical record or on designation documentation packets.

· Performs daily checks of and cleans equipment such as but not limited to monitors, code equipment, crash cart checks and oxygen cylinders.

· Prepares and administers medications using the rights established by the State Board of Nursing of state employed and facility policies and procedures.

· Uses clear, concise, professional communication with coworkers, patients, all customers internal and external.

· Uses AIDET in interactions with patients and family members. Utilizes white boards for patient communication.

· Collaborates across disciplines to coordinate patient care, including but not limited to patient transfer, discharge, referrals, and spiritual/psychosocial support needs.

· Monitors patients using proper equipment as ordered.

· Triages patients appropriately using the ESI (Emergency Severity Index) system.

· Arrives to work prepared to receive patient report on time.

· Provides discharge instructions, follow up care and education to patients and family members.

· Abides by HIPAA (Health Insurance Portability and Accountability Act) regulations.

· Utilizes SBAR (Situation, Background, Assessment, Recommendation) when communicating with oncoming shift, physician communication and giving report to ancillary or other nursing services.

· Utilize the Nursing Process ADPIE (Assessment, Diagnosis, Planning, Implementation, Evaluation) to secure individualized and methodical patient care.

· Speaks up to stop the line and escalates potential safety events if necessary.

· Acts quickly, appropriately and with a sense of urgency and prioritization in delivery of patient care.

· Stabilizes patients by coordination with medical staff providers, EMS (Emergency Medical Services), coworkers, patients, and family members in a professional, calm manner.

· May float to other areas of the hospital as assigned.

· Stocks assigned rooms, keeps work areas clean.

· Attends and/or completes monthly, annual, and assigned training.

· Other duties as assigned.

Definitive Observation Unit:

· Monitors EKG output and keeps doctor informed of any changes.

· Recording vital signs, including oxygen levels, blood pressure, breathing patterns etc.

· Deliver regular updates to doctors, patients, and their families.

· Manage ventilators and artificial airways

BEHAVIORAL STANDARDS:

· Treats everyone as their customer; utilizes scripting and other tools to ensure consistency in customer service; Expresses recognition and shows appreciation to others; fully utilizes AIDET principles; responds quickly to handle requests, complaints, and questions; displays a positive attitude.

· Demonstrates the highest level of professionalism, passion and care when interacting with patients, families, physicians, and hospital staff members.

· Using a lens of equity in all aspects of patient care delivery, education, and research to promote policies and practices to allow opportunities for all to thrive and reach their potential, embracing ingenuity to service our customers.

COMMUNICATION/KNOWLEDGE:

· Wears nametag properly; follows dress code policy; answers phone correctly and promptly; is prepared for meetings; meets deadlines; does not participate in gossip; acts ethically and treats others with respect; respects customer's and co-worker's time; establishes and maintains effective relationships with customers and co-workers.

COLLABORATION/TEAMWORK:

· Attends staff meetings; follows HIPAA guidelines; follows patient rights policy; complies with the compliance program; demonstrates knowledge of role in a disaster; demonstrates knowledge of fire and fire drill procedures; working knowledge of hospital emergency codes; always utilizes standard precautions in the clinical setting; safely manages the environment of care by demonstrating a working knowledge of the requirements of the: Life Safety program, Utilities Management program, Hazardous Materials program, Emergency Preparedness program, Safety Management program, Medical Equipment Management program, Security Management program.

Licensure/Certifications:

DOU: · Vent Certification and/or experience preferred. · Advanced Cardiovascular Life Support (ACLS) from American Heart Association (AHA), required.