Registered Nurse - Acute Rehab - FT Midnights 7pm - 7:30am - Including every 3rd weekend

Department

Acute Rehab

Schedule

• Full time Midnights 7 pm - 7:30 am, Weekdays and every 3rd weekend

Hospital

Henry Ford Health Genesys

Location

Grand Blanc, Michigan

Sign On Bonus

• $10,000

Responsibilities

• Use independent professional judgment, analytical skills, and the nursing process to provide a full range of delegated, interdependent, and independent nursing services to patients.
• Within the framework of the Seven Dimensions of Patient Care and Benner's Domains of Nursing Practice, demonstrates clinical competence; compassion and customer service orientation; focus on process and outcomes; and cost-consciousness when assessing, planning, implementing, and evaluating nursing care provided to patients.
• Seven Dimensions of Patient Care: Coordinate development of a multi-disciplinary plan of care in accordance with Nursing Problem Care Sets (Core Outcomes and Core Intervention Sets) and/or clinical practice guidelines, age-specific requirements and professional and regulatory requirements to ensure appropriate length of stay, use of resources, and achievement of quality outcomes.
• Provide patient care that reflects a respect for patient's rights, dignity, values, culture, preferences, and expressed needs. Assess patient/family needs for information and education across the continuum, plans and implements patient teaching using a variety of techniques and methods, and evaluates effectiveness of educational interventions.
• Help to alleviate patient fears and anxiety through skilful application of professional and interpersonal communication.
• Utilize a variety of pharmacologic and non-pharmacologic approaches to ensure patient comfort and relief of pain. Involves patient, family, significant others in development of plan of care.
• Collaborate with patient/family, hospital staff, and community agencies to develop discharge plans that prepare patients for continued care needs.
• Orientation Self-Evaluation: (C) Competent (NT) Needs Training or Review.
• Standards of Performance: - Seven Domains of Nursing Practice. - Helping/Teaching & Coaching: - Incorporate all elements of Signature Care in Daily interactions with patient:
• Introduce self and writes name on whiteboard.
• Discuss plan of care with patient/family.
• Explain meds and treatments, provide teaching as appropriate.
• Ask if patient needs anything else before leaving room.
• Assess health status and determines care needs of the patient. Performs ongoing reassessment as required.
• Complete Admission Assessment and shift assessment as required.
• Complete assessment for Risk Factors; including fall, skin breakdown, VTE, and aspiration. Initiate appropriate initiatives as indicated SKINN Bundle, Fall Prevention Plan, SCD, etc.
• Complete Medication Reconciliation upon admission and change in level of care.
• Establish, direct, coordinate and document plan of nursing care in conjunction with patient/family.
• Initiate Problems and Outcomes list (plan-of-care) based on medical diagnosis and patient needs.
• Monitor, document, and report patient response to interventions and progress toward outcomes.
• Document nursing interventions (NIC) and progress toward outcomes (NOC); patient education; and evaluation every shift, as required.
• Educate patient regarding treatment plan, safety measures, medications, and self-care as indicated. Document education activities on shift assessment flowsheet and plan of care (POC).
• Work with Case Manager to ensure appropriate referrals initiated prior to discharge.
• Review discharge plans/instructions with patient prior to discharge, including signs/symptoms to watch for after leaving the hospital. Ensures appropriate follow-up arranged.
• Ensure that core measures Discharge Instructions are given to all CHF patients.
• Document patient care according to established documentation guidelines.
• Administration of Therapeutic Regimens:
• Demonstrate knowledge and skill application of basic nursing procedures - dressing change, catheterization, NG tube insertion, suctioning.
• Implement/complete medical interventions as ordered. Initiate standing orders appropriately. Initiate and/or assists with all patient care activities including activities of daily living and provides other services as required for patient comfort, safety, and well-being.
• Assess and initiate interventions to prevent/minimize patient skin breakdown.
• Follow clinical practice guidelines and procedures as written.
• Establish and maintain peripheral IV therapy.
• Obtains body fluid specimens, per procedure.
• Obtains blood specimens if no phlebotomist assigned to area.
• Performs blood capillary glucose monitoring.
• Administer the following according to established policies and procedures: - Medications. - IVs. - Blood products.
• Prepare patients for surgery or other invasive procedures according to established guidelines.
• Perform or assist with procedures according to established standards of care and nursing practice.
• Utilize equipment based on manufacturers instructions and established nursing procedure. Correctly operates and trouble shoots IV pumps, PCA pumps, epidural pumps, feeding pumps, patient beds, as applicable.
• Monitor Patient Responses/Responding to Changing Patient Situations.
• Regularly reviews work in progress to ensure that treatments, medications, and tests ordered are expeditiously carried out and documented.
• Review patient medical record/reports and confers with physician regarding treatment plans. Routinely checks chart for new orders.
• Maintain awareness of patient physiologic parameters including vital signs, lab work, I&O, blood glucose; recognizes and reports meaningful changes and intervenes appropriately. Documents interventions accordingly.
• Maintain awareness of patient's pain on admission, after pain producing events, with each new report of pain, and routinely at regular intervals.
• Informs patient about pain relief and pain relief measures; administers pain medication or alternative interventions as indicated; includes pain management resources in the discharge plan/instructions.
• Recognize acute changes in respiratory status - dyspnea, cyanosis, tachypnea, respiratory depression, airway obstruction and responds - appropriately with direct intervention and physician/SWAT notification.
• Recognize acute changes in neurologic status/decreased LOC and responds appropriately with direct intervention and physician/SWAT notification.
• Recognize acute changes in cardiac status - tachycardia, chest pain and responds appropriately with direct intervention and physician/SWAT notification.
• Recognize acute changes in urinary output and responds appropriately with direct action and physician notification.
• Utilize SBAR tool or other standardized approach to data collection and information sharing when notifying physician of patient changes/concerns.
• Respond appropriately to life-threatening emergencies through initiation of CPR, assembly of emergency equipment, and immediate interventions (as allowable and indicated).
• Perform emergency equipment checks.
• Provide appropriate support/summons appropriate resources for families in crisis/grieving process. Ensuring Quality of Health Care Practices.
• Communicate with other professionals/departments and physician staff to ensure appropriate progress of patients through the system.
• Maintain awareness of individual patient length of stay (LOS); notifies case manager and nurse manager of potential LOS/discharge issues.
• Identify ethical issues related to patient care (including issues related to advanced directives) and initiates steps for resolution.

Qualifications

• Licensed Registered Nurse (RN)
• Current BLS certification
• Experience in acute care setting preferred

Skills

• Proficiency in computer systems
• Excellent communication and interpersonal skills
• Ability to work independently and as part of a team

Benefits

• 5% Market Pay Differential
• Increased Night Shift Premium - 10%
• $2 Weekend Differential

Pay

• Commensurate with experience

Organization and Work Role

• Provide input on appropriate patient care assignments; taking into consideration patient condition and knowledge/experience/work load of staff.
• Provide direction and leadership to other staff by: - Clearly communicating expectations/responsibilities to team members. - Observing patients and work in progress periodically throughout the shift.
• Communicating with team members about work to be completed/problems encountered.
• Assisting team members with patient care activities as needed.
• Assisting other "teams" as situation requires.
• Use the 4 Ps (patient, pertinent issues, picture, plan) to give appropriate and pertinent information at change-of-shift and/or transfer.
• Participate in the creation and maintenance of a healthy work environment by: - Treating co-workers with respect. - Communicating to co-workers with respect; resolving conflicts and/or negative feelings promptly, privately, and appropriately. Taking responsibility for personal actions, behaviors, and attitudes and not displacing anger or frustration onto co-workers, patients, or families.
• Communicating appropriate patient care issues/concerns to nurse manager.
• Respond appropriately to changes in unit workloads, patient census, and/or staffing levels.
• Interpersonal skills necessary in order to interact with patients/families, other nursing staff members, physicians, and other hospital personnel.
• Ability to concentrate and pay close attention to detail when planning and performing professional nursing care, resolving patient care problems, and dealing with patients and families; often during stressful situations.
• Ability to walk or stand continuously and frequently lift and position patients.