Registered Nurse, ICU

Location 2800 E. ROCK HAVEN ROAD,HARRISONVILLE, MO, 64701,United States Job Category PROFESSIONALS, Critical Care, RN Employee Type PRN Job Code 1520

CASS REGIONAL MEDICAL CENTER

Job/Position Description Department Name: ICU Title: Registered Nurse, ICU EEOC Classification: Professional/Non-Exempt PART ONE: Dimension and Description Primary Purpose To provide critical care in accordance with hospital policies and procedures, as well as state and federal regulations. Stay informed of current trends and changes in the healthcare industry. The purpose is also to provide a safe and caring environment for patients and families during stressful situations. Formal Policy-Setting Responsibilities No formal responsibility. The policies associated with the job’s purpose and essential responsibilities are set by others. Routine Decision Making Determines which condition warrants notification of physician; which medications are needed during critical times; which equipment should be used for each patient. Formal Supervisory Responsibility No formal supervisory responsibility. Required Knowledge Critical care medications; IV drips; assessments; cardiac dysrhythmias; knowledge of specialized equipment; nursing process; growth and development, disease processes; interpretation of lab results. Required Skills and Ability Excellent physical assessment skills; observation; auscultations; palpation; good communication skills; ability to function independently; excellent time management and prioritization skills; computer skills; problem-solving skills; knowledge of hospital policies and procedures. Unusual Working Conditions Risk of blood or body fluid contamination. Education and Certification/ Registration required for the Position RN degree, BSN preferred; current licensure in the state of Missouri; BLS required within 30 days of hire, ACLS, PALS and TNCC required within 6 months of hire and NIH Stroke Certification within 90 days of hire. Age Specific Competencies May provide care for birth to pediatric (birth-2 yrs.), pediatric/child patients between (2 yrs-12 yrs); adolescent patients between 12 to 18 years of age; adult patients between 18 to 64 years; and geriatric patients 65 years and older. PART TWO: Essential Responsibilities and Tasks A. Demonstrates utilization of the nursing process through patient assessment. (20% of time)

1. Assesses and evaluates the patient's condition at the beginning of each shift.
2. Re‑assesses and evaluates the patients approximately every four hours and as needed.
3. Completes the admission database thoroughly, which includes a pertinent patient history, assessment of body systems, medication history and other screenings, within one hour of arrival to the ICU, as acuity allows.
4. Assesses data relative to age specific needs for every patient within 1 hour of patient's arrival to the unit or at the beginning of each shift.
5. Completes appropriate pain assessment at the beginning of each shift and as needed.
6. Ensures all patients are placed in the ICU within thirty minutes of being notified of the admission/ transfer if bed is available.

B. Demonstrates utilization of the nursing process through planning for patient care. (15% of time)

1. Collaborates with interdisciplinary team to facilitate the plan of care.
2. Completes an individualized care plan and update as appropriate, based on patient diagnosis and assessment.
3. Plans for increased staffing needs according to patient acuity and according to written departmental staffing patterns, notifying nursing management as appropriate.
4. Interprets the significance of abnormal patient findings during each assessment and as patient's condition changes.
5. Updates white boards each shift, to include personalized patient goals.

C. Demonstrates utilization of the nursing process through implementation of nursing and medical interventions. (20% of time)

1. Implements nursing and medical interventions/rounding hourly and as needed.
2. Demonstrates professionalism and competence during emergency situations, acting rapidly and efficiently, and managing self and others to implement patient care according to current standards of practice and hospital policy.
3. Demonstrates accountability to physician orders through timely implementation and notation of such orders.
4. Interprets appropriately the significance of abnormal assessment findings.
5. Documents and reports significant abnormal patient findings to the physician immediately.
6. Is knowledgeable of the location, operation and care of all equipment in the ICU.
7. Administers all medications as ordered within one hour of time scheduled according to the five rights on every patient.
8. Ensures all physician orders are correctly recorded on eMAR, on patient's kardex and in the computer when noting each order.
9. Accurately and correctly wastes unused portions of controlled substances prior to the end of every shift.
10. Performs narcotic count according to hospital policy.
11. Attaches patient's name band, allergy band, etc. immediately after patient's arrival or upon band(s) being removed.
12. Utilizing the ‘AIDET’ model, conducts an appropriate introduction, reviews the plan of care, mutually sets attainable patient goals.

D. Demonstrates utilization of the nursing process through evaluation of patient care. (10% of time)

1. Evaluates patient responses to implemented interventions according to current standards of care and to hospital policy.
2. Communicates specific patient responses to implemented care as needed to the physician, obtains necessary modifications to the medical and nursing plan of care.
3. Adapts the individualized plan of care for each patient as conditions change.

E. Demonstrates accountability to the nursing process through documentation. (10% of time)

1. Documents assessments at least every four hours, including cardiac rhythm strips with interpretations.
2. Documents according to the written plan of care at least once per shift.
3. Documents clearly the implementation of specific interventions, including details of methods used, with the time of implementation, and evaluation of patient response.
4. Documentation follows hospital and departmental policies for frequency and content.
5. Utilizes only hospital approved abbreviations in documentation and clarifies non-approved abbreviations utilized by others.

F. Provides patient and family education. (10% of time)

1. Provides patient and/or family education based on assessments each shift.
2. Uses terminology appropriate to patient/family's knowledge base and age-specific needs each shift.
3. Evaluates patient and family's learning needs and abilities each shift and as needed.
4. Documents education provided including subject taught, method of teaching, who was taught and comprehension of information.
5. Provides and documents patient and family follow‑up instructions at discharge.

G. Maintains a safe and comfortable unit. (10% of time)

1. Checks code blue carts each shift and upon using the cart, ensuring it has an intact tag attached.
2. Ensures alarms on any assigned areas are audible to alert staff, each shift.
3. Removes malfunctioning equipment from the direct patient care areas immediately upon discovering a problem.
4. Completes a requisition for repair and and sends electronic work request before the end of the shift.
5. Utilizes the two hospital approved patient identification methods for positive patient identification.
6. Utilizes correct method of bar code scanning patient identification bracelets for medication administration via eMAR 97% of the time.
7. Utilizes correct method of bar scanning patient medications for medication administration via eMAR 95% of the time.
8. Completes patient assignment/ patient acuity record each shift.

H. Develops and promotes performance improvement initiatives. (5% of time)

1. Plans, develops and evaluates self objectives annually.
2. Participates in planning methods to solve problems and make improvements in the Intensive Care Unit quarterly and as needed.
3. Participates in implementing planned changes and activities to improve the Intensive Care Unit quarterly and as needed.
4. Evaluates planned changes and activities to improve the Intensive Care Unit quarterly and as needed.
5. Participates on hospital/unit teams: (3) two or more teams, (2) one team, (1) no participation on teams.
6. Attends unit staff meetings (3) 80% or greater, (2) 50-80%, (1) less than 50% annually.

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