Registered Nurse - Emergency Department

About us: For the past 85 years, Stephens County Hospital has been a trusted name in the community, striving for excellence and delivering professional and compassionate care. Our dedicated staff of approximately 475 employees has a heart for healthcare and realizes how precious the gift of good health can be.


Stephens County Hospital is a 96-bed acute care hospital located in Toccoa, Georgia. We are nestled in the beautiful foothills of Northeast Georgia where our family-oriented community offers many cultural and civic opportunities as well as numerous outdoor activities.

Stephens County Hospital is a member of the Georgia Hospital Association, American Hospital Association and Georgia Alliance of Community Hospitals. Stephens County Hospital is fully accredited by the Joint Commission, the nation's premier healthcare monitoring agency.

Registered Nurse - Emergency Department


Full Time Positions Available:


7pm - 7am (36 hours)


7pm - 3am (32 hours)

Education:


Graduate of an approved diploma, associate or bachelor nursing program.

Experience:


Emergency Room experience preferred.

Licensure/Certification:


BLS certification to be obtained within first month of employment.


Current Georgia License as a Registered Nurse.


ACLS certification within six months of employment, or first available class.

The Staff Nurse provides care to patients of the indicated ages :


Infants (Newborn to One Year) Adolescent (Ten to 18 Years)


Toddlers (Two to Four Years) Adult (19 to 69 Years)


Child (Five to Nine Years) Geriatric (70 and Above)

Duties and Responsibilities

• Maintains and monitors central lines.
• Monitors heart rate and oximeter readings and intervenes appropriately.
• Evaluates and documents signs and symptoms of distress.
• Monitors conscious sedation patients per protocol.
• Equipment competency:
  • External pacer/defibrillator, Plaster splinting, EMS radio equipment, Gastric lavage equipment, Infant scales, Cast cutter, Hare traction splinter
• Demonstrates ability to prioritize and assign appropriate categorization during triage.
• Initiates treatment protocols.
• Triage documentation meets established requirements.
• Monitors waiting room for new patients.
• Responds to triage quickly.
• Keeps families informed of patient condition.
• Demonstrates ability to assist with specific procedures.
  • Chest tube insertion, Suturing, Peritoneal lavage, Tracheotomy, Lumbar punctures, Thoracentesis, Central line insertion, GYN exams, Traction placement, Application of casts/splints, Sexual assault exams
• Stocks supplies of department each shift.
• Notifies manager of diminished supply levels.

• Utilizes cephalo-caudal approach to physical assessment.
• Develops assessments to include: Nutritional Screening, Fall/Risk, Functional, Pain, Skin Integrity, Cultural/Spiritual, Psycho-social, DVT Risk, Suicide, and Pneumococcal/Flu.
• Identifies complex problems in the assessment and initiates the plan of care utilizing nursing problems when appropriate.
• Notifies physician and charge nurse of any pertinent assessment findings.
• Reviews and updates plan of care to reflect changes in patient status.

• Demonstrates competency in clinical skills and knowledge pertinent to the practice and education of the Registered Nurse.
• Implements the physician's orders promptly and appropriately with understanding of the purpose of each as it relates to the patient's plan of care.
• Monitors the patient's condition and maintains accurate documentation (vital signs, alertness, mobility, condition of wound or operative site, etc.).
• Reports abnormalities or instability of the patient's condition in a timely manner to appropriate persons (charge nurse, physician, director, administrative supervisor, CARE Team).
• Ensures readiness of chart for procedure or surgery (pre-op checklist, lab, EKG, x-ray and documentation in the nurse's notes).
• Responsible with assistance of patient and/or family for surgery site marking by provider if applicable.
• Coordinates the care and preparation of patients for procedures, treatments or surgery (proper prep, dress and premedication).
• Assesses the patient upon return from surgery or other procedures and documents findings in the patient care profile.
• Performs verification (time out) prior to invasive procedures as designated by policy.
• Responds appropriately and timely to clinical alarms (IV pumps, monitor alarms, bed alarms, etc.).
• Implements Pain Management program.
• Performs and documents hourly rounding, or as appropriate for unit.
• Ensures the patient's hygienic needs are met (AM care, PM care, toileting, etc.).
• Implements and monitors restraint use per policy.
• Consults other disciplines as indicated by assessment findings.
• Administers emergency resuscitation of patients in cardiac arrest.
• Implements and maintains standard or high fall risk precautions as indicated.
• Confirms two patient identifiers (name, date of birth and/or hospital number) when providing care and specimen collection.
• Charge Nurse Responsibilities:
  • Makes appropriate staff assignments to include coverage for patient care during meals and breaks.
  • Acts as liaison between physicians, patients, visitors and staff.
  • Demonstrates ability to make prompt decisions based on sound judgment.
  • Demonstrates critical thinking skills.
  • Assumes responsibility for completeness and quality of nursing care provided by staff assigned to the unit
• Administers medications in a safe, timely manner and correctly documents their administration.
• Utilizes two patient identifiers before giving medication according to policy.
• Records the patient's response to the medications in the patient care profile when appropriate.
• Uses 5 "R"s for administering medications.
• Demonstrates knowledge of drugs used.
• Identifies and reports adverse drug reactions per policy.
• Demonstrates proper use of pyxis: Resolves all discrepancies before end of shift. Utilizes override feature in appropriate situations.
• Performs venipuncture per policy.
• Maintains and accesses central lines/PICC's.
• Administers blood products.
• Checks and documents status of IV/INT per department policy.
• Demonstrates proper use of IV equipment.
• Adheres to medication reconciliation policy.
• Adheres to principles of medication security.
• Obtains narcotics from PYXIS/Pharmacy and documents administration and wastes per policy.
• Assesses/monitors PCA patients per policy.
• Gathers information pertinent to the medication(s) ordered: actions, purpose, normal dosage and route, common side effects, time of onset and peak action, nursing implications.
• Performs real-time documentation.
• Conforms to department documentation standards.
• Reports and records pertinent information related to nursing plan of care.
• Demonstrates proficient use of computer and adheres to departmental policy.
• Records accurately in the medical record nursing actions: Reflect care given to the patient, Observations made about the patient, Patient's response to treatments or medications, Restraints, Pain Management.
• Complies with "Do Not Use Abbreviations".
• Repeats and verifies all verbal/phone orders and test results.
• Provides the patient with an explanation of his/her condition and written information when possible.
• Participates in pre and post-operative teaching of surgical patients.
• Includes family and/or significant other in health teaching when possible.
• Plans with the patient, family, and/or significant other for discharge.
• Reviews home care instructions with patient or responsible party and document same in the patient care profile/discharge form.
• Initiates consultation with other health care professionals.
• Extends courtesy and demonstrates cooperation while communicating with others.
• Gives a concise, pertinent report to the oncoming nurse providing opportunity for questions.
• Utilizes effective communication skills with patients, families, Charge Nurse, Medical Staff, Director, Administrative Supervisor, peers and co-workers in a pleasant positive manner.
• Accepts suggestions and criticisms and whenever necessary undertakes to change personal behavior or seek further guidance.
• Delivers hand off communication when care provided or level/location of care changes.
• Effectively leads and directs activities of others in a positive manner.
• Assumes relief charge nurse, team leader or patient care responsibilities as necessary.
• Demonstrates flexibility and adaptability rotating to another shift or unit when need arises.
• Supports the philosophy, policies and procedures of the Division of Nursing.
• Assumes responsibility for completeness and quality of nursing care provided by his/her team members including private duty nurses, nursing students and supplemental staff.
• Demonstrates skill in supervising subordinates in performing their duties.
• Participates in Nursing Service Quality Improvement activities in evaluating patient care (QI studies, monthly monitoring, etc.)
• Participates in the orientation process of new employees.
• Maintains BLS certification.
• Possesses certification in ACLS, PALS, NRP or area of practice:
• Utilizes universal precautions in all aspects of work practice.
• Initiates appropriate isolation procedures.
• Maintains knowledge of multi drug resistant organisms and measures to be initiated.
• Remains in compliance with hospital Hand Hygiene Policy.
• Reports staff deficits related to compliance with Infection Control practice (non-compliance with hand washing, isolation procedures, and maximum barrier precautions.)
• Complies with maximum barrier precautions during central line insertions.
• Complies with policies regarding vascular lines (dressing changes, appropriate insertion techniques.)
• Inserts Foleys using sterile technique.
• Maintains knowledge of hospital acquired infection rate and measures being taken to decrease incidence.
• Teaches patients and families regarding infection prevention and transmission.
• Administers antibiotics timely specifically related to SCIP, community acquired pneumonia and CAUTI measures.
• Assures timely collection of patient cultures.
• Cleans equipment appropriately between patient and/or staff use.

AGE SPECIFIC COMPETENCIES


Infant (Newborn-One Year)

• Provides protective environment; does not leave unattended.
• Assesses and interprets data relative to patient's age.
• Involves parents in administration and planning of care.
• Evaluates for age appropriate behavior, motor skills and physiological norms.
• Determines and documents head circumference.
• Evaluates and documents for signs/symptoms of abuse and neglect.
• Determines and documents immunization status.
• Demonstrates sensitivity to cues that indicate infant is overstressed and initiates appropriate soothing measures.
• Prepares and administers medications based on weight, age and sensitivity.
• Provides equipment specific to patient's age and size.
• Assesses nutritional status according to age; intervenes if appropriate.

Toddler (2 to 4 Years)

• Assesses and interprets data relative to patient's age.
• Involves parents in administration and planning of care.
• Evaluates for age appropriate behavior, motor skills and physiological norms.
• Evaluates and documents for signs/symptoms of abuse and neglect.
• Determines and documents immunization status.
• Prepares and administers medications based on weight, age and sensitivity.
• Involves child in own care when possible.
• Recognizes comprehension level and verbal ability.
• Speaks and plays with the toddler to effectively reduce stress.
• Provides equipment specific to patient's age and size.
• Assesses nutritional status according to patients age; intervenes if appropriate.

Child (5 to 9 Years)

• Assesses and interprets data relative to patient's age.
• Involves parents in administration and planning of care.
• Evaluates for age appropriate behavior motor skills and physiological norms.
• Evaluates and documents for sign/symptoms of abuse and neglect.
• Determines and documents immunization status.
• Prepares and administers medications based on weight, age and sensitivity.
• Provides equipment specific to patient's age and size.
• Recognizes child's need to exercise some control.
• Provides for privacy.
• Assesses for non-verbal needs for support.
• Keeps an explanation short, simple and logical using correct terminology.
• Anticipates possible need for homebound education.
• Recognizes the child's need for independence and potential for being attracted to dangerous situations.
• Assesses nutritional status according to age; intervenes if appropriate.

Adolescent (10 to 18 Years)

• Assesses and interprets data relative to patient's age.
• Evaluates for age appropriate behavior, skills and physiological norms.
• Evaluates and documents for signs/symptoms of abuse and neglect.
• Determines and documents immunization status.
• Prepares and administers medication based on weight, age and sensitivity.
• Provides equipment specific to patient's age and size.
• Involves patient in decision making and planning for care and teaching.
• Allows for privacy and anticipates fear of embarrassment.
• Uses proper medical terminology.
• Allows adolescent to maintain control and realizes there may be resistance.
• Encourages questions regarding "fears".
• Evaluates self-care abilities/limitations and identifies need for additional safety measures.
• Assesses nutritional status according to age; intervenes if appropriate.

Adult (19 to 69)

• Evaluates self-care abilities/limitations and identifies need for additional safety measures.
• Assesses and interprets data relative to patient's age.
• Evaluates and documents for signs/symptoms of abuse and neglect.
• Prepares and administers medication based on weight, age and sensitivity.
• Provides equipment specific to size of patient.
• Involves patient in planning of care and educational needs.
• Recognizes anxiety regarding potential changes in lifestyle resulting from illness.
• Addresses patient appropriately.
• Explains procedures using correct terminology.
• Recognizes patient's level of psychosocial development and modifies interventions accordingly.
• Provides for patient's privacy.
• Respects patient's right to refuse treatment.
• Assesses nutritional status according to age; intervenes if appropriate.

Geriatric (70 Years and Older)

• Evaluates self-care abilities/limitations and identifies need for additional safety measures.
• Evaluates and documents for signs/symptoms of abuse and neglect.
• Assesses and interprets data relative to patient's age.
• Prepares and administers medications based on weight, age and sensitivity.
• Provides equipment specific to size of patient.
• Recognizes anxiety regarding potential changes in lifestyle resulting from illness.
• Addresses patient appropriately.
• Explains procedures using correct terminology.
• Provides for patient privacy.
• Respects patient's right to refuse treatment.
• Recognizes patient's level of psychosocial development and modifies interactions accordingly.
• Assesses for limiting conditions (vision, hearing, elimination, etc.).
• Implements skin integrity and/or risk to fall protocols.
• Provides for patient warmth due to decreased heat regulation.
• Allows patient to discuss thoughts and plans related to death and dying.
• Assesses nutritional status according to age; intervenes if appropriate.

Knowledge, Skills, and Abilities

• Ability to compile, code and categorize, or verify information/data
• Strong organizational and interpersonal skills
• Ability to determine appropriate course of action in more complex situation
• Ability to work independently, exercise creativity, and maintain a positive attitude
• Ability to manage multiple and simultaneous responsibilities and to prioritize scheduling of work
• Ability to maintain confidentiality of all medical, financial, and legal information
• Ability to complete work assignments accurately and in a timely manner
• Ability to communicate effectively, with excellent verbal and written communication skills

Non-Essential Functions

• Perform other duties as assigned or requested.

Professional Requirements

• Adhere to dress code, appearance is neat and clean.
• Complete annual education requirements.
• Maintain patient confidentiality at all times.
• Report to work on time and as scheduled.
• Wear identification while on duty.
• Maintain regulatory requirements, including all state, federal and local regulations.
• Represent the organization in a positive and professional manner at all times.
• Comply with all organizational policies and standards regarding ethical business practices.
• Participate in performance improvement and continuous quality improvement activities.
• Attend regular staff meetings and in-services as needed.

Physical Requirements and Environmental Conditions

• Physically demanding, high-stress environment
• May be up walking on feet up to 6-8 hours per day
• Must be able to lift 10 pounds or more
• Sitting - continuously within the shift (55-90%)
• Standing - frequently within the shift (30-50%)
• Walking - frequently within the shift (30-50%)
• Climbing - occasionally within the shift (1-33%
• Bending/stooping - frequently within the shift (34-66%)
• Twist at the waist - occasionally with the shift (1-33%)
• Pushing/pulling - frequently within the shift (34-66%)
• Lift/carry - 20lbs with assistance - occasionally within the shift (1-33%)
• Reaching above the shoulders - frequently within the shift (34-67%)
• Lift/carry - 50lbs with assistance - occasionally within the shift (1-33%).

Stephens County Hospital is an equal opportunity employer. All applicants will receive consideration for employment without regard to race, color, religion, sex, age, pregnancy, marital status, national origin, citizenship status, disability, military status, sexual orientation, genetic predisposition, carrier status or any other legally protected status.