Registered Nurse ED - PTI - Night Shift

Job Description

Job Description

Primary FunctionThe Emergency Department (ED) serves as the critical hub of the Cherokee Indian Hospital, delivering high-acuity, patient-centered care to individuals of all ages. Excellence in clinical skill and critical thinking is expected, as the ED demands rapid decision-making and expert execution under pressure. Nurses are expected to exemplify the highest standards of professionalism, consistently demonstrating a positive attitude, cultural sensitivity, and adherence to the hospital’s guiding principles. Each interaction reflects a commitment to treating patients and families with dignity, compassion, and the same level of care one would offer their own loved ones. The RN’s role directly impacts patient outcomes and supports the ED’s vital role as the core of the hospital’s mission.
Job Description

Patient Care & Assessment

• Provides nursing care per established standards.
  • Performs comprehensive, ongoing patient assessments using biological,

psychological, social, and cultural data.

• Recognizes patient needs for health promotion, prevention, maintenance,

and restoration.

• Develops and initiates individualized plans of care based on assessments

and diagnoses.

• Establishes expected outcomes that are measurable and time-bound.

Planning & Implementation

• Plans for basic patient needs: nutrition, hygiene, activity, rest,

oxygenation, comfort, coping.

• Implements nursing interventions aligned with care plans.
• Revises care plans based on patient response and changing needs.
• Provides health education and anticipatory guidance tailored to patient/family understanding.

Medication & Documentation

• Administers medications per protocol; documents per policy.
• Monitors for side effects, allergies, and reports medication errors.
• Documents assessments, interventions, outcomes, and communication accurately.

Leadership & Coordination

• Provides guidance and training to nursing staff.
• Leads team when assigned; delegates based on staff competency and patient needs.
• Coordinates referrals to support, community, and tribal services.
• Promotes patient advocacy and maintains confidentiality.

Quality & Safety

• Maintains a safe, clean environment; follows universal precautions and OSHA standards.
• Participates in quality improvement and risk management activities.
• Ensures adequate supplies and proper equipment function.
• Serves on committees as appointed.

Professional Development

• Maintains current competency through education and training.
• Participates in nursing quality assurance and performance evaluations.

Education/Experience

• Required
• Associate Degree in nursing from accredited program required.
• Applicant must have an unrestricted Registered Nurse license valid to practice within the state of North Carolina.
• Basic Life Support (BLS) required within 90 days of hire.
• Advanced Cardiac Life Support (ACLS) and Pediatric Advanced Life Support (PALS) which can be acquired through the facility following appointment to position. ACLS and PALS must be acquired within 6 months of date entering on duty.
• TNCC and ENPC within a year of hire date.

• Preferred
• Graduated from an accredited Bachelor of Science in Nursing program, and critical care experience preferred.
• Proficiency rated at 1 year for an RN with one-year clinical nursing experience.

Job Knowledge

Clinical Nursing Knowledge

• Understands nursing principles, practices, and theories across all age

groups—from infants to elderly.

• Proficient in the nursing process and applying it to patient care.
• Understands disease processes, signs of complications, and appropriate

interventions.

• Knowledgeable in medication effects, dosages, side effects, and

complications.

Scope of Practice & Legal/Ethical Standards

• Clear understanding of RN, LPN, and CNA roles.
• Familiar with legal and ethical standards in nursing.
• Experienced in documentation using problem-oriented medical records.

Patient-Centered Care

• Skilled in teaching and counseling patients/families on health maintenance

and disease prevention.

• Culturally competent with awareness of patient population needs.
• Knowledge of community health resources and programs.

Clinical Judgment & Equipment Use

• Able to analyze medical data and apply appropriate interventions.
• Skilled in using medical equipment (monitors, suction, oxygen, etc.).

Teamwork & Leadership

• Understands roles of the multidisciplinary team.
• Capable of leading, organizing, and prioritizing work in high-pressure

settings.

• Experience in setting, evaluating, and revising nursing standards.

Complexity of Duties

• Demonstrate flexibility, emotional intelligence, and the ability to lead

individuals with varied work styles and personalities.

• Maintain professionalism, integrity, and composure in high-pressure and

fast-paced environments.

• Provide comprehensive nursing care, including:
  1. Patient assessment and care planning
• Medication administration and therapeutic interventions
  1. Use of specialized medical equipment
• Evaluation of patient outcomes
• Physical and psychosocial support
• Patient and family education
• Recognize and respond promptly to changes in patient condition; identify,

analyze, and report contributing factors.

• Practice in accordance with the Nurse Practice Act, professional standards,

organizational policies, and applicable regulations.

• Deliver care through a trauma-informed, culturally responsive approach,

honoring each patient’s unique background.

• Exercise independent clinical judgment when guidelines do not fully

address patient-specific situations, critical thinking skills are essential.

• Collaborate with Nurse Manager, providers, and other clinical leaders

when addressing complex or atypical scenarios.

Geriatric Emergency Department Nurse Champion Responsibilities

As the Geriatric Emergency Department (GED) Nurse Champion , this role includes the following responsibilities aligned with GEDA accreditation requirements:

• Team Leadership & Education
• Lead and support the GEDA team in developing and implementing geriatric-specific care processes.
• Provide ongoing education to nursing staff on geriatric emergency care, utilizing resources such as the Geriatric Emergency Nursing Education (GENE) course or NICHE training.
• Assist in protocol development to ensure best practices in geriatric patient care.
• Protocol Implementation & Workflow Coordination
• Implement and oversee geriatric-specific protocols, ensuring adherence to accreditation standards.
• Coordinate interdisciplinary team efforts to optimize workflow for older adult care in the ED.
• Quality Improvement & Outcome Monitoring
• Track, document, and report on key geriatric care metrics, ensuring continuous improvement.
• Participate in quality assurance initiatives focused on geriatric patient outcomes.
• Geriatric Patient Advocacy & Environment Enhancements
• Ensure appropriate physical plant modifications to improve the geriatric patient experience.
  1. Advocate for resources and policy changes that enhance geriatric care in the ED.
• GED Accreditation Compliance & Institutional Collaboration
  1. Maintain compliance with GEDA accreditation standards by documenting training, certifications, and ongoing education.
  2. Act as a liaison between ED leadership and hospital administration to align geriatric initiatives with institutional goals.

Supervision Received

The nurse independently plans, schedules, and provides nursing care in coordination with the medical care plan and attempts to solve problems only within established procedures. This is done under the supervision of Emergency Department Nurse Manager or his/her designee. The work is evaluated for technical soundness and adherence to professional standards.

Responsibility for Accuracy

The incumbent has a positive effect upon the recovery of the patient and is responsible for following policies and procedures, which serve as hospital guidelines and prevents errors from occurring. Errors can have a negative patient outcome since the incumbent’s performance affects the health, recovery, and rehabilitation of patients, and the quality of care provided. Evaluations and observations are used to modify and develop clinically appropriate treatment plans. Work can be verified or checked by the immediate supervisor, other health care providers or systems checks, but usually the responsibility for accuracy relies solely on the incumbent.

Contact with Others

Contacts are with patients, families, hospital personnel, and community agencies. Contacts with patients, families, and hospital personnel are to exchange, provide, and obtain information concerning the patient’s physical and psychosocial health care problems, and needs. The nurse uses teaching and counseling methods to influence and motivate patient and family behavior. Contacts with other health care or related disciplines within the hospital are for the purpose of collaboration and consultation.

Confidential Data

The incumbent has access to highly confidential patient medical and personal information. The Privacy Act of 1974 mandates that the incumbent shall maintain complete confidentiality of all administrative, medical, and all other pertinent information that comes to his/her attention or knowledge. The Act carries both civil and criminal penalties for unlawful disclosure of records.

Violations of such confidentiality shall be cause for adverse action.

Mental/Visual/Physical

Work in the various services within the nursing department requires considerable walking, standing, bending, pushing, and lifting in helping patients to and from beds, wheelchairs, and stretchers. These same activities are required in moving equipment and medical supplies. May occasionally move more than 15 pounds.

Environment

The work environment involves moderate risks of exposure to infectious disease, radiation, electrical hazards, irritant chemicals and explosive gases.

Customer Service

Consistently demonstrates superior customer service skills to patients/customers by demonstrating characteristics that align with CIHA’s guiding principles and core values. Ensure excellent customer service is provided to all patients/customers by seeking out opportunities to be of service.