Registered Nurse - (PRN) Days

Job Title: Registered Nurse (RN)

Department: Nursing

Reports To: Nurse Director

FLSA Status: Non-Exempt

Position Summary: Delivers care to patients utilizing the nursing process of assessment, planning, intervention, implementation, and evaluation, in accordance with established protocol and / or as ordered by the emergency room physician to restore stability, prevent complications, and achieve and maintain optimal patient responses for all patients through patient centered/patient valued care.

Essential Duties and Responsibilities: To perform this job successfully, an individual must be able to perform the following Clinical, Laboratory, and general essential duties and responsibilities satisfactorily; other duties may be assigned. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

· Maintain accurate, detailed reports and records.

· Administer medications to patients and monitor patients for reactions or side effects.

· Record patients' medical information and vital signs.

· Monitor, record, and report symptoms or changes in patients' conditions.

· Monitors patients receiving moderate / procedural sedation and reports the patient’s condition and response to the emergency physician.

· Consults and coordinates with health care team members to assess, plan, implement and evaluate patient care plans.

· Performs triage and assessments using a standardized acuity tool (e.g., Emergency Severity Index / ESI).

· Manages basic life support needs and stabilizes patients until the attending physician is available, based upon nursing standards and protocol; coordinates stabilization and transfer of patients requiring a higher level of care in accordance with facility transfer protocols, including report to EMS and the receiving hospital.

· Initiates corrective action whenever information from monitoring equipment shows adverse symptomatology.

· Works under the direction of the emergency physician, assisting during exams, procedures, diagnostic testing and treatments.

· Provides IV infusion / therapy in accordance with physician orders, performs 12-lead EKG, venipuncture and IV initiation, blood draws, cardiac and pulse oximeter monitoring, applies oxygen using the appropriate delivery system, administers nebulized treatments.

· Provides emergency nursing care to patients across the lifespan, from neonate through geriatric, applying age-specific assessment and treatment.

· Participates in the initial recognition and management of time-sensitive emergencies (e.g., STEMI, stroke, sepsis, and trauma) with rapid stabilization and escalation.

· Supports on-site diagnostic imaging by preparing and monitoring patients for X-ray, CT, and ultrasound, including monitoring for reactions to contrast media as ordered.

· Assists administration in maintaining proper / par-level supplies and appropriate medical equipment to care for patients.

· Reports any violations of policies, procedure and any suspected abuse to the appropriate agencies.

· Initiates patient education plan, as prescribed by physician. Teaches patients and significant others how to manage their illness/injury.

· Reviews all discharge instructions with patient and take vital signs prior to discharge to ensure patient is stable

· Reports safety violations, work injuries, or work hazards to administration.

· Accounts for on hand narcotics amounts at each shift change in the presence of a qualified healthcare professional, i.e., RN, physician and records narcotic count into appropriate log.

· Logs medication inventory and removal of medications for administration as required by pharmacy policy and ensures security of the pharmacy during shift.

· Complete all necessary chart nursing documentation in accordance with policy. Documentation must be legible and in English.

· Performs quality assurance reviews of charts as designated by administration.

· Maintains all clinical proficiencies and annual training as required by facility policy.

· Performs duties as assigned for venous blood draws for blood and body fluid samples. Uses drawn samples to perform and complete such laboratory point of care testing and send out labs as ordered by the on-duty physician.

· Reports abnormal lab testing to the health care provider as soon as possible and without delay.

· Posts such completed lab results to the chart.

· May perform or assist with daily/monthly QC’s to ensure proper performance and compliance in the laboratory.

· Fulfills requirement of annual laboratory proficiency testing.

· Reports any diversion from normal lab operations or incidents to the Nurse Director, i.e., exposures, incidents, spills, injuries, etc.

· Maintains confidentiality of patient related issues as outlined by HIPAA and company policies.

· Ensure emergency room and treatment areas operate within the compliance standard with Federal, State and applicable accrediting agencies.

· Comply with the guidelines set forth in the Infection Control and Prevention Plan and any applicable Center for Disease Control (CDC) requirements relative to the operations of the facility.

· May be required to travel at the discretion of the Governing Board. May be required to drive personal or company provided vehicles; and/or travel by airplane as needed.

· Position is subject to require overtime. Such position may include being required to work extended hours during the week, weekends, and holidays and during periods in which a state of emergency has been declared.

Competencies: To perform the job successfully, an individual should demonstrate the following.

Adaptability - Accepts criticism and feedback; Adapts to changes in the work environment; Changes approach or method to best fit the situation; Manages competing demands

Attendance/Punctuality - Arrives at meetings and appointments on time; Begins working on time; Ensures work responsibilities are covered when absent; Keeps absences within guidelines; Schedules time off in advance

Communications - Exhibits good listening and comprehension; Expresses ideas and thoughts in written form; Expresses ideas and thoughts verbally; Keeps others adequately informed; Selects and uses appropriate communication methods

Continuous Learning - Assesses own strengths and weaknesses; Pursues training and development opportunities; Seeks feedback to improve performance; Shares expertise with others; Strives to continuously build knowledge and skills

Customer Service - Displays courtesy and sensitivity; Manages difficult or emotional customer situations; Meets commitments. Responds promptly to customer needs; Solicits customer feedback to improve service

Problem Solving - Develops alternative solutions; Gathers and analyzes information skillfully; Identifies problems in a timely manner; Resolves problems in early stages; Works well in group problem solving situations

Teamwork - Balances team and individual responsibilities; Contributes to building a positive team spirit; Exhibits objectivity and openness to others' views; Gives and welcomes feedback; Puts success of team above own interests

Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education/Experience:

· Graduate of an accredited nursing program

· Current registered nursing license (in good standing with the Texas State licensing board)

· Minimum of three (3) years Emergency Room (ER) Nursing Experience

· Current certifications of AHA Healthcare Provider CPR, Advanced Cardiac Life Support (ACLS), Pediatric Advanced Life Support (PALS)

· Preferred: Trauma Nursing Core Course (TNCC), NIH Stroke Scale (NIHSS), Certified Emergency Nurse (CEN), and crisis-prevention / de-escalation training (e.g., CPI)

Language Ability:

Read, interpret and apply clinical orders, protocols and policies. Communicate clearly with patients, families and the care team, including structured hand-off (e.g., SBAR) and report to EMS and receiving facilities.

Mathematical Ability:

Accurately perform medication dosage calculations, weight-based pediatric dosing, IV drip and infusion rate calculations, and clinical unit conversions.

Reasoning Ability:

Define problems, collect data, establish facts and draw valid conclusions. Interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables.

Computer Skills:

Computer literate; must be able to utilize electronic record keeping programs, copier/scanner, etc.

Certificates and Licenses:

Maintains all required certifications and licenses as required by 26 TAC §509.46 (Facility Staffing and Training).

Work Environment: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this Job, the employee is frequently exposed to moving mechanical parts and risk of electrical shock. The employee is occasionally exposed to fumes or airborne particles; toxic or caustic chemicals and risk of radiation. The employee may be exposed to various contagious diseases or conditions that have the potential of being physically, emotionally, and/or psychologically harmful. The noise level in the work environment is usually moderate.

Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this Position, the employee is regularly required to stand and walk for periods ranging from 6 to 12 hours at a time. Ability to bend, lean and stoop without hindrance; full range of body motion. Use hands and fingers, handle, or feel; reach with hands and arms; sit, climb or balance; stoop, kneel, crouch, or crawl; talk and hear. The employee is occasionally required to sit in short or extended intervals as required. The employee must frequently lift and/or move more than 50 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.

The above job description is not intended to be an all-inclusive list of duties and standards of the position. Incumbents will follow any other instructions, and perform any other related duties, as assigned by their supervisor.