Registered Nurse - PACU II: Part-Time, 5am-3:30pm, Mon-Fri. No weekends or on-call. Holiday as required.

General Summary

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, demonstrate 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.

Department

PACU II

Schedule

Part-Time, 5a-3:30p, Mon-Fri. No weekends or on-call. Holiday as required.

Hospital

Henry Ford Health Genesys

Location

Grand Blanc, Michigan

Standards of Performance

• Seven Domains of Nursing Practice
• Helping/Teaching & Coaching: Incorporate all elements of Signature Care in Daily interactions with patient

Orientation Self-Evaluation

(C) Competent (NT) Needs Training or Review.

Admission Assessment and Shift Assessment

• 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.
• Perform 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; recognize and report meaningful changes and intervene appropriately. Document interventions accordingly.
• Monitor presence and intensity 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; administer 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 respond - appropriately with direct intervention and physician/SWAT notification.
• Recognize acute changes in neurologic status/decreased LOC and respond appropriately with direct intervention and physician/SWAT notification.
• Recognize acute changes in cardiac status - tachycardia, chest pain and respond appropriately with direct intervention and physician/SWAT notification.
• Recognize acute changes in urinary output and respond 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 individual patient length of stay (LOS); notify case manager and nurse manager of potential LOS/discharge issues.
• Identify ethical issues related to patient care (including issues related to advanced directives) and initiate steps for resolution.

Quality of Health Care Practices

• Communicate with other professionals/departments and physician staff to ensure appropriate progress of patients through the system.
• Maintain individual patient length of stay (LOS); notify case manager and nurse manager of potential LOS/discharge issues.
• Identify ethical issues related to patient care (including issues related to advanced directives) and initiate steps for resolution.

Organizational 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.
• Communicate with team members about work to be completed/problems encountered.
• Assist team members with patient care activities as needed.
• Assist 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.
• Communicate appropriate patient care issues/concerns to nurse manager.
• Respond appropriately to changes in unit workloads, patient census, and/or staffing levels.
• 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.

Working Conditions

Normal patient care environment with moderate exposure to excessive noise, dust, temperature, etc. Frequent exposure to communicable diseases, hazardous substances, and moderately adverse Working Conditions due to performance of patient care activities.

Orientation Requirements

This position, aside from the above requirements, will require approximately three (3) to nine (9) months on-the-job experience in order to acquire and effectively apply knowledge of unit and departmental policies, procedures, and standards for patient care and professional nursing practice.