RN STAFF 3 (OR - FT)

Position Summary

Responsibilities include but are not limited to: The assessment, planning, implementation and evaluation of nursing care for patients and their families in a safe environment. Functions as a Proficient nurse (Benner, Novice to Expert Nursing Theory) within the competency checklist of assigned unit. Accountable for effective leadership and direction to the nursing care team ensuring patients' comfort, safety and personal care. Must be able to perform jobs in all patient care and operational areas subject to reasonable accommodations, also be able to employ all mandatory safety devices and procedures. Must participate in the Respiratory Protection Program, which may include the wearing of a respirator which requires a clean shaven face. This is a union position.

ESSENTIAL JOB FUNCTIONS

1. Clinical Practice
   • Performs comprehensive assessment on assigned patients.
     1. Assesses patient condition thoroughly, utilizing information obtained from physician, health team members, family and diagnostic measures.
     2. Recognizes signs and symptoms that indicate real and potential problems.
     3. Distinguishes between clinically relevant and irrelevant data.
     4. Identifies patient and family level of knowledge and understanding of illness and managing health and identifies language and learning barriers.
     5. Identifies discharge planning needs.
     6. Recognizes cardiac arrhythmias and changes in hemodynamic status consistent with unit standards.
   • Develops individualized comprehensive documented plan of care for all patients.
     1. Accurately identifies patient needs based on interpretation of observations and clinical knowledge and judgment.
     2. Sets priorities and makes decisions in timely manner.
     3. Develops individual plan of care with realistic outcome criteria and adjusts this plan on a continuing basis.
     4. Knows physician’s plan for patient, expected length of stay, outcome criteria and discharge goals. Communicates them to patient/significant others and other members of the healthcare team.
     5. Demonstrates knowledge of CORE measures and other relevant quality standards in developing plan of care.
     6. Incorporates evidence-based care in the development of the patient’s plan of care.
   • Implements patient care.
     1. Demonstrates competency in performing safe nursing care for patient population based on unit standards.
     2. Able to relate interventions to patients’ condition and recognizes interrelationships of patient problems (actual and potential) and pathophysiology.
     3. Logically sequences nursing care to meet patient needs within defined time frames.
     4. Displays understanding of standard pharmacological agents used in treating patient conditions in assigned unit. Safely administers medication according to policy.
     5. Includes ongoing patient education within care delivery, including wellness strategies, and keeps patient informed of the treatment modalities.
     6. Recognizes, reports and corrects unsafe practice.
     7. Demonstrates primary concern for infection control and for patient safety including utilization of “time outs” prior to procedures.
     8. Independently utilizes complex equipment and supplies.
     9. Able to problem solve, troubleshoot and take corrective measures in care and handling of equipment.
     10. Recognizes, intervenes in and appropriately directs life threatening patient situations.
     11. ICU only: Manages hemodynamics requiring titrations of multiple pharmacological infusions.
     12. ICU only: Recovers CT surgery patients in the first 24 hours post‑operatively.
     13. Telemetry only: Demonstrates efficiency in caring for patients pre/post catheterization and/or categorized as rapid evaluation chest pain patients meeting established time frames.
     14. Telemetry only: Demonstrates safe sheath removal and groin management.
     15. OR, Endoscopy, Cath Lab: Assists in patient preparation according to routine of the procedure to be done.
     16. OR, Cath Lab: Keeps constant vigilance of movements and techniques of all personnel to insure no break in aseptic technique; speaks up when breaks are identified.
     17. OR, Cath Lab: May be asked to scrub‑in to assist physician and perform the hemodynamic monitoring of patient, after being trained to act as a resource person at each skill.
     18. Cath Lab: Demonstrates safe sheath removal and groin management.
     19. OR only: Circulates for general cases; able to scrub for minor procedures.
     20. OR only: Circulates for major, specialty cases (ortho or heart cases).
     21. OR only: Circulates and scrubs for major, specialty cases (ortho or heart cases).
     22. OR only: Captures peri‑operative data for surgery registries.
   • Evaluates patient response to nursing care and medical regimen.
     1. Continually monitors each patient’s response to treatment and consults with other health team members in the modification and re‑assessment of the plan of care.
     2. Promptly recognizes and interprets changes in patient’s physiological and psychosocial status and reports timely to shift management and physician, activating emergency response system as needed.
   • Communicates patient care concisely and completely.
     1. Documents completely, per unit standards, patient history and physical assessment findings as well as ongoing observations and assessments and care delivered.
     2. Documentation is completed concurrently per unit standards.
     3. Provides documented plan of care for all patients updating and revising as needed.
     4. Communicates pertinent findings to appropriate health personnel.
     5. Keeps shift management informed.
     6. Oral communication is professional, respectful using the SBAR format.
2. Leadership and Coordination
   • Contribute to Administrative function of Nursing Unit.
     1. Inspires harmonious teamwork and actively promotes a positive work atmosphere.
     2. Anticipates and recognizes problem/conflict/crisis situations and actively engages in finding resolutions.
     3. Practices within and promotes awareness of legal responsibilities (Joint Commission, Title 22, Hospital Policy and Procedures).
     4. Reviews, revises or develops nursing policies and procedures as directed with assistance.
     5. Demonstrates understanding of organizational structure by utilizing chain of command appropriately.
     6. Promotes communication and cooperation within physicians, coworkers and other health team members.
     7. Nursing practice reflects values of the hospital.
   • Demonstrates leadership, integrity, fiscal responsibility, teamwork, and service excellence.
   • Supports and promotes Unit and Hospital goals.
   • Assists with the development and implementation of Unit goals and objectives.
   • Utilizes organizational skills and effective cost containment methods in completing daily assignments.
   • Delegates responsibility appropriately considering overall unit needs and resources.
   • Contributes to staff meetings.
   • Attendance expectations:
     • Meets expectation: 80% attendance
     • Exceeds expectation: Above 80% attendance
   • May be required to work other shifts, weekends and/or be on‑call.
   • OR, Endoscopy, Cath Lab: Must take call on a rotating basis with a 30‑minute response time.
   • Fulfills relief charge nurse responsibilities as assigned.
   • Maintains a clean, organized work environment.
   • Maintains departmental readiness at all times (i.e. restocking, equipment checks, room preparation).
   • Offers suggestions for work improvement.
   • ED only: Serves as triage nurse.
   • ED only: Effectively manages department flow as charge nurse or while in Fast Track.
   • OR only: Using physician preference cards, ensures that OR room is ready prior to case start time.
3. Supports and participates in hospital wide quality improvement program
   • Reports (written/verbal) unusual circumstances in timely manner.
   • Identifies topics/problems for process improvement study.
   • Participates in process improvement teams designing and analyzing changes.
   • Participates in quality improvement data collection as requested.
   • Makes recommendations based on PI team’s findings. Initiates actions with approval and guidance.
   • Incorporates quality improvement recommendations into clinical practice.
4. Professional Growth
   • Demonstrate role of professional RN to other health team members, patients and public.
     1. Fosters desirable attitude and work habits through example of own professional behavior and interest.
     2. Responds to float assignments in a professional manner performing core nursing tasks.
     3. Demonstrates flexibility as patient census and care needs change.
     4. Completes assigned duties in a timely manner; independently performs assigned tasks.
     5. Implements and promotes change.
     6. Recognizes own knowledge level and limitations; seeks out assistance, resources and references.
     7. Maintains professional discretionary standards and confidentiality within hospital and community.
     8. Utilizes professional organization associated with specialty to increase unit specific clinical knowledge.
   • Acts as educational resource.
     1. Acts as a preceptor and resource person.
     2. Coordinates orientation for individual staff member as assigned and evaluates progress/additional learning needs, keeping documentation up‑to‑date according to department standards and keeping unit management informed.
     3. Provides clinical instruction to unit staff as directed.
   • Supports professional research.
     • Shares current literature and research findings informally and formally with unit staff.
     • Incorporates current literature and research findings into clinical practice.

Qualifications

• Education required to qualify for license as a registered nurse. B.S.N. preferred.
• Experience: To qualify as an RN III, must have 12 months experience within the last three years within the specialty area. Clinical experience must enable the applicant to demonstrate clinical competencies, including demonstrating EKG rhythms by exam, within probationary period.

Unit Specific

• Medical‑Surgical, Orthopedic, Telemetry Units: Must have and maintain national certification in medical‑surgical care or critical care nursing.
• Classification as RN III in one specialty does not apply if transfers to another specialty area until requirements are met in the new specialty.

Licenses/Certificates

• Current California Registered Nurse License
• Current Basic Life Support (BLS) Certification through American Heart Association (AHA) required
• Current Advanced Cardiac Life Support (ACLS) Certification through AHA required
• Current National Institutes of Health Stroke Scale (NIHSS) Certification required
• Current Pediatric Advanced Life Support (PALS) Certificate through AHA required for the following: Emergency, Pre‑Op, OR/PACU, and Endoscopy Department.

Other

FTE: 1.0 - 8 HOURS - DAYS