RN RRT

Job Description Summary

Responsible for the planning, delivery and management of direct patient care utilizing the nursing process and adhering to the standards of nursing practice. Acts as a resource to staff in inpatient, ED and outpatient units. Manages individualized, outcome oriented nursing care through the use of the nursing process. Provides care, treatment and services through the successful coordination and completion of a series of processes that include assessment, planning care, providing care, in accordance with departmental and hospital policies and procedures

Job Description

1. MEDICATION ADMINISTRATION

a. Demonstrates knowledge of and follows SSH policies and procedures for administering, transcribing, and recording medications.
b. Completes medication reconciliation process following SSH policy and procedure.
c. Demonstrates proper procedure for the documentation of narcotic withdrawal, administration, verifies count, wastes per policy and resolves narcotic discrepancy.

2. PLAN OF CARE/DOCUMENTATION/PATIENT FAMILY CENTERED CARE/PATIENT EXPERIENCE - Develops, discusses, and communicates a prioritized problem list/plan of care for each patient.

a. Develop, evaluate and update individualized plan of care for patient and documents outcomes.
b. Initiating admission assessment within 8 hours of admissions, identifies and documents patient/family/significant other teaching needs upon admission and throughout hospitalization.
c. Continues assessment/reassessment and identifies care needs within established nursing practice.
d. Documents all patient care following the department of nursing policy, unit based standards, disease processes (CHF, PNA vaccines) and nurse sensitive indicators (falls, skin, CAUTI)
e. Assess/reassesses and documents patient's level of comfort utilizing the appropriate pain scale and the patient's response to each intervention both pharmacological and non-pharmacological per South Shore Hospital policy.
f. Works on behalf of patient /family. Seeks help to represent patient/family when they are unable to represent themselves.
g. Raises ethical questions and concerns with clinical team. Seeks available resources to help formulate and understand ethical decisions.
h. Actively communicates plan of day via white board updating every shift.
i. Facilitates discharge/transfer by goal of 12:00pm, communicates barriers utilizing chain of command.

3. SAFETY/QUALITY - Foster's a "Culture of Safety" through personal ownership and commitment to a safe environment.

a. Verifies patient identification with two identifiers prior to the start of any invasive procedure, including "time out", administration of care, medications, labeled specimen's an documents confirming the correct patient, procedure, site, equipment and consent.
b. Complies with the current CDC hand hygiene guidelines through proper handwashing. Adheres to universal precautions, makes appropriate use of personal protective equipment at all times and appropriately disposes of hazardous materials. Maintains awareness of MSDS sheets and how to access.
c. Ensures environment meets regulatory requirements at all times.
d. Understands and is able to demonstrate individual roles and responsibilities in the event of hospital codes/emergency preparedness.

4. PROFESSIONAL DEVELOPMENT - Assumes overall responsibility for own professional development by incorporating evidenced-based practice, research, and performance improvement initiatives as a part of ongoing nursing practice.

a. Obtains at least 5 contact hours per year in area of practice.
b. Practices within the legal boundaries of MA Nurse Practice Act. Directs other licenses and non-licensed personnel as assigned.
c. Displays the ability to accept and respond appropriately to feedback and recommendations for change.
d. Demonstrates professional working relationships with colleagues from all disciplines to promote a positive/encouraging workplace.
e. Critical Thinking: analyzes causes of problems, identifies and evaluates alternative solutions, and selects appropriate solution, and communicates appropriately and effectively utilizing chain of command.
f. Accountable for being informed about changes in hospital policy and procedure.

5. TECHNOLOGY - Utilizes technological solutions to work processes and practices.

a. Access Lotus Notes to review email, learning management and other resources as applicable to RN role.
b. Utilizes software applications required by department and unit standards.
c. Accountable to understand how to operate in downtime.

6. COMPLIANCE

a. Works within legal, regulatory and ethical standards relevant to the position.
b. Complies with applicable policies and procedures.
c. Safeguards the privacy and security of patient information. The employee compiles will policies and procedures relating to SSH’s privacy and security programs.
d. Brings potential compliance issues to a manager, supervisor, director or VP.
e. Complies with the mandatory education requirements of the compliance, privacy and security programs.

7. PATIENT AND FAMILY CENTERED CARE

a. Conveys respect for values, preferences, and expressed needs of the patient and family.
b. Recognizes the patient, and family according to patient preferences, as important members of the health care team.
c. Collaborates with the patient, and family according to patient preferences, in planning, implementing, and evaluating care.
d. Welcomes the presence and participation of family members at all times according to patient preferences, regardless of rounds, change of shift, or other events on unit.

8. AGE & CULTURE

a. Possesses age and cultural knowledge and awareness.
b. Considers the individual needs of each person with whom they interact.
c. Interacts with sensitivity in the delivery of care/services of diverse populations as needed.
d. Effectively utilizes resources to provide care/services - such as, interpreter services and on-line sources.

9. DEPARTMENT RRT SPECIFIC

a. Demonstrates knowledge of RRT protocols and participates in RRT calls as assigned.
b. Participates in Code 9 calls as assigned.
c. Assists nursing staff in the treatment and stabilization of patients experiencing clinical deterioration.
d. Acts as a clinical resource to nursing staff in the medical management of patients exhibiting clinical deterioration and their associated signs and symptoms.
e. Assists the ACC, Patient Flow Facilitator in maintaining patient flow issues by supporting the transfer of unstable patients to their designated clinical area.
f. Collaborates effectively with other members of the health care team in the treatment and management of patients undergoing an RRT.
g. Completes all documentation required for RRT calls in accordance to policy and procedures.

10. CRITICAL CARE / ICU SKILLS AND KNOWLEDGE

a. Demonstrates the ability to obtain a 12-lead EKG and respond with appropriate interventions.
b. Demonstrates the ability to care for the patient with continuous cardiac monitoring including rhythm identification, interpretation and follow through with appropriate interventions.
c. Demonstrates the ability to titrate intravenous medications according to the patient’s hemodynamic status and policy and procedures.
d. Demonstrates the ability to care for a patient with hemodynamic monitoring including insertion, monitoring, interpretation, and care of the CV catheter.
e. Demonstrates the ability to care for the ventilated patient.
f. Demonstrates the ability to titrate insulin infusion according to the patient's blood sugar and protocol.
g. Demonstrates the ability to care for the patient with a permanent pacemaker/ICD including monitoring, interpretation of rhythm and care of the site.
h. Demonstrates the ability to care for the patient with a temporary pacemaker including insertion, monitoring, interpretation of rhythm and care of the catheter/wire.
i. Demonstrates the ability to care for the patient receiving thrombolytic protocol for neuro event.
j. Demonstrates the ability to care for the post operative/post procedure patient including recognition of post operative/procedure complications and nursing actions taken to reduce incidence of complications.
k. Assists in the care for the patient with IABP including monitoring, interpretation of wave form, care of the catheter and trouble shooting of system (CCU).
l. Assists in the care for the patient with ICP monitoring including assisting in the placement and set up as well as interpretation and follow through with appropriate interventions (SICU and MICU).
m. Assists in the care for a trauma patient (SICU and MICU).

11. ED SPECIFIC SKILLS AND KNOWLEDGE

a. Demonstrates the ability to care for the patient with compromised respiratory status.
b. Demonstrates proper skills related to care of the ventilated patient.
c. Demonstrates the ability to perform IV cannulation and assessment of infiltration, extravascularization.
d. Collaborates with the ED Clinical Flow Facilitator and ACC in supporting ED flow and decompression measures.

JOB REQUIREMENTS
Minimum Education - Preferred
Graduate of an accredited School of Nursing. Bachelor's degree in Nursing preferred.
Minimum Work Experience
2 years of medical/surgical experience
2 years of critical care experience for the clinical resource nurse

Required Licenses / Registrations

RN - Registered Nurse

Required Classes/Certifications
ACLS - Advanced Cardiac Life Support.

Required additional Knowledge, and Abilities

Demonstrated proficiency in acute care nursing, knowledge, and skills. An equivalent combination of education and experience, which provides proficiency in the areas of responsibility listed above, may be substituted for the above requirements for licenses, etc.