Med/Surg Registered Nurse - Per Diem

Summary
The registered nurse renders highly professional and technical nursing care to assigned patients. The registered nurse provides direct and indirect patient care using the nursing process (assessment, planning, implementation, and evaluation). Oversees other assigned team members and collaborates with a multidisciplinary team to provide population specific care in accordance with the BORN regulations and professional standards of care.
The STAT Registered Nurse supports the care of unstable and critically ill patients throughout the Hospital when census and/or acuity dictate.
The Device Clinic RN performs a variety of patient care and technical duties in our outpatient Device Clinic, including interrogation and programming; trans-telephonic pace-maker follow-up; and follow-up of patients participating in research studies and clinical trials in cardiac pacing.
Specialty Area Additional Requirements: (Adult GI, ARTC, Cancer Center, Cardiovascular Center, Device Clinic, ED, ICU, L&D/AETU, Maternal Fetal Medicine, Med/Surg, Mother/Baby, OR, PACU/Henderson, Pediatrics, Pedi GI, Psychiatry, SCN, STAT RN, Primary Care Triage RN included)
Adult GI: 2 years Critical Care/GI experience required, unless otherwise noted in job posting. ACLS required within first year of employment, CCGRN certification preferred.
Assisted Reproductive Technologies Clinic (ARTC): As a dual practice, supporting BWH and MGH fertility practices, the ART nurse must have the ability to provide competent compassionate care and should demonstrate advanced knowledge of reproductive health and treatment options. BSN is required upon employment and the competitions of the ASRM RN certificate course within 1st year of employment. Minimum 1 year working in reproductive endocrinology practice is required.
Cancer Center: Minimum one year experience administering chemotherapy single agent and multi drug regimen in the outpatient setting required. Thorough assessment skills and knowledge of Hematology/Oncology disease pathophysiology, acute and chronic side effects of treatment required. Knowledge and experience in medical oncology nursing required, unless otherwise noted in job posting. 3 years' experience in ambulatory oncology nursing strongly preferred. Oncology Nursing Certification (OCN) or obtained within first year of hire required .Chemotherapy/Biotherapy Administration Certification Card required. Oncology Nursing Society strongly preferred.
Cardiovascular Center: 2 years Critical Care experience required. Cardiac ICU, CCU, or Cardiac Surgery, Cath Lab experience preferred unless otherwise noted in job posting. Previous interventional radiology and/or electrophysiology experience required; proficiency in IV catheter insertion and IV sedation in an acute procedural setting preferred. BLS/ACLS certification required upon employment.
Device Clinic: The Device Clinic RN performs a variety of patient care and technical duties in our outpatient Device Clinic, including interrogation and programming; trans-telephonic pace-maker follow-up; and follow-up of patients participating in research studies and clinical trials in cardiac pacing. 2 years device clinic experience with pace maker programming and clinic follow-up required. Basic Cardiac Life Support (BCLS), and Advanced Cardiac Life Support (ACLS) certifications required. HRS/NASP certification preferred.
ED: 2 years ED experience required, unless otherwise noted in job posting. ACLS, PALS, and CPI certifications required within first year of employment. CEN or CCRN preferred.
ICU: 2 years Critical Care experience required, unless otherwise noted in job posting. ACLS is required within first year of employment.
Labor & Delivery/AETU: Experience with Fetal Monitoring is preferred. 2 years L&D experience required, unless otherwise noted in job posting. NRP required within the first year of employment.
Maternal Fetal Medicine: Performs perinatal procedures for high risk pregnant population in the Maternal Fetal Medicine Practice at Newton-Wellesley Hospital. Assists in a standardized approach to Fetal Monitoring following the Nursing Standards of Fetal Monitoring Care. Minimum of two years of clinical experience in perinatal services is required. Minimum 1 year working in reproductive endocrinology practice is required. BSN in Nursing is required. BLS is required prior to hire. ACLS is preferred.
Med/Surg: 1 year Med/Surg experience is required, unless otherwise noted in job posting. Telemetry experience is preferred as telemetry training is required within the first year of employment.
Mother/Baby: Experience with Fetal Monitoring is preferred. 2 years Mother/baby experience required, unless otherwise noted in job posting. NRP required within first year of employment.
OR: Completion of a Peri-operative Nursing Program preferred. 2 years OR experience required, unless otherwise noted in job posting. AORN certification preferred.
PACU/Henderson: 2 years Critical Care/PACU experience required, unless otherwise noted in job posting. PACU: ACLS and PALS required within first year of employment. PACU/Henderson: CPAN/CAPA certification preferred.
Pediatrics: 2 years Pediatrics experience required, unless otherwise noted in job posting. NRP required within first year of employment when cross trained for mother/baby.
Pedi GI: 2 years Pedi GI experience required, unless otherwise noted in job posting. PALS required within first year of employment.
Psychiatry: 2 years Psychiatry experience required, unless otherwise noted in job posting. CPI required within first month of employment.
SCN: 2 years SCN experience required, unless otherwise noted in job posting. NRP required within first year of employment.
STAT RN: The STAT Registered Nurse supports the care of unstable and critically ill patients throughout the Hospital when census and/or acuity dictate. 2 years Critical Care/Emergency nursing experience required, unless otherwise noted in job posting. ACLS, PALS and CPI required within first year of employment.
Primary Care Triage RN: 2 years Triage, ER, Urgent Care, or Out Patient experience required, unless otherwise noted in job posting. Ambulatory Care Nursing Certification ANCC RN-BC preferred.

Does this position require Patient Care?
Yes

Essential Functions
-CAREfirst:


-Adheres to the general hospital standards to promote a cooperative work environment by utilizing communication skills, interpersonal relationships, and team building.


-Follows departmental policies and procedures.


-Contributes to the overall quality of services.


-Assumes responsibility for keeping informed about changes.


-Makes independent decisions within the scope of nursing practice.


-Uses the nursing process and evidence based practice to ensure quality patient care is provided throughout the episode of care.


-Assesses the patient's physical, psychological, spiritual, cultural, and social needs.


-Provides competent and compassionate care specific to the unique needs of the individual patients and populations served.


-Individualizes care in consideration of the patient's age, developmental, or physical abilities (including obesity); spiritual, religious or cultural practices; economic status; literacy skills; communication skills; cognitive abilities; and gender or sexual orientation.


-Updates knowledge and skill of populations served to meet patient care needs.


-Applies knowledge of illness, injury, and disease in the assessment process and recognizing those symptoms that need immediate intervention.


-Individualizes a plan of care based on assessments and in collaboration with the patient/family/ significant other, as well as, appropriate resources and multidisciplinary team members.


-Engages patient/family/significant others as partners in caring.


-Updates plan of care and nursing documentation based on continuing assessments.


-Implements clinical and technical aspects of care and physicians' orders in compliance with standards of practice and standards of care.


-Evaluates the patient/family/significant other's responses to established goals and interventions and revises the plan of care based upon this evaluation.


-Demonstrates the ability to set priorities when planning and implementing patient care.


-Coordinates and collaborates with appropriate resources and multidisciplinary team members to facilitate a comprehensive discharge plan.


-Recognizes change in patient's physical and mental status and informs physician and /or another health care professional.


-Collaborates with Case Managers to anticipate discharge needs and address barriers.


-Identifies person primarily responsible for care at home and includes them in patient teaching and discharge planning.


-Creates and maintains a safe and therapeutic environment for patients, self, and co-workers.


-Uses two patient identifiers to match the correct patient with the correct care, treatment, or services.


-Demonstrates through practice principles of infection control and universal precautions, adherence to OSHA standards, Hazardous Material Guidelines, and isolation procedures.


-Safeguards the rights of patients and hospital personnel to privacy by judiciously protecting information of a confidential manner.


-Provides patient comfort and hygiene.


-Demonstrates proper use of equipment and supplies according to established procedures.


-Assesses the patient's need prior to application of restraints and utilizing alternative measures for restraints when appropriate.


-Demonstrates proper technique and calibration of equipment when performing point of care testing.


-Assures equipment is operational and safe or removed from service.


-Responds appropriately to emergency situations.


-Minimizes risk of injury by promoting fall precautions, use of call bell, side rails, and other safety practices.


-Treats patients and family in a non-judgmental respectful manner.


-Takes the initiative to advocate for the patient.


-Makes patient aware of his rights and responsibilities.


-Provides emotional, psychological, and spiritual support to patient and family needs.


-Assures quality of nursing practice through participation in performance improvement activities.


-Incorporates performance improvement recommendations into daily practice.


-Controls patient care cost through: Efficient management of supplies and services.


-Suggestions of new approaches to cost containment.


-Participates in performance improvement activities by evaluating outcomes of patient care and making recommendations for appropriate revisions to the individualized plan of care.


-Ensures complete, accurate, and timely written communication of patient information.


-Completes consistently all parts of the documentation system per hospital/unit policies.


-Ensures appropriate documentation on or in patient's discharge instructions.


-Documents patient's progress or lack of progress in a chronologically accurate and organized format.


-Provides safe, accurate, and timely medication and IV administration.


-Consistently uses the "5 rights" when administering medication to patients.


-Scans patient, medication, and self barcodes where applicable.


-Demonstrates knowledge of drug action and appropriate nursing interventions for adverse drug reactions.


-Verifies or rectifies patient medication record per unit protocols.


-Demonstrates critical assessment of correct drug, appropriate dose, and correct pump settings when caring for patients with continuous large volume infusion, PCA, or Epidural.


-Demonstrates/verbalizing appropriate recognition, reporting of medication variances and problems with the medication process.


-Verifies and analyzes appropriateness of medication/IV fluid orders.


-Ensures correct infusion rates when administering medications using the infusion pump.


-Coordinates and collaborates with other multidisciplinary team members to facilitate a comprehensive educational plan.


-Assesses the need for patient/family/significant other education.


-Formulates and implements an educational plan that is based on assessed needs and takes into consideration learning barriers and spiritual/religious cultural needs.


-Documents education in the patient record.


-Evaluates outcomes of education plan, monitors learning process, elicits feedback from patient/family/significant other, and modifies instruction based on evaluation process.


-Judgment and Decision Making:


-Takes personal responsibility for own performance and professional growth and development.


-Initiates and facilitates changes to improve quality of nursing care on the unit.


-Demonstrates the ability to accept responsibility and be accountable for the care given to assigned patients.


-Demonstrates the ability to work well with co-workers and to collaborate with other members of the health care team.


-Accepts and learns from constructive criticism.


-Is self-directed in maintaining clinical competence, mandatory training, and other regulatory requirements.


-Performs duties of charge nurse, as needed, competently.


-Acts as a resource and professional role model for peers and students.


-Assists in orientation and ongoing support of new staff.


-Advocates for the patient by escalating care concerns up the chain of command.


-Manages urgent and emergent situations effectively.


-Communicates effectively.


-Promotes a cooperative working environment by using effective communication skills.


-Communicates and addresses conflicts with appropriate personnel, utilizing listening skills and showing sensitivity.


-Communicates expectations to assigned team members with tact and in clear, concise, and thorough manner.


-Solves problems effectively.


-Ensures that critical patient information and data are communicated across the continuum of care.


-Supports and promotes management decisions, goals and initiatives.


-Device Clinic RN Role Specific Responsibilities:


-Enrolls, interrogates, and programs outpatient pacemaker patients.


-Recognizes abnormalities, malfunctions, and End of Service indicators; notifies cardiologist and assists in scheduling patients for follow up or replacement as indicated.


-Coordinates and prioritizes with other members of the healthcare team to respond to, plan, and initiate timely and efficient care.


-Educates patients and families regarding device function and clinic follow up routine.


-Forwards information to referring physicians.


-Ensures timely and proper documentation and billing.


-Leads device recall team.


-Responsible for administrative duties of all device trans-telephonic monitoring, including purchase orders, billing issues, and reporting.


-Oversees Cardiac Arrhythmia Service event monitoring.


-Provides cross-coverage as necessary.


-Serves as a resource to staff, other departments, and administration; provides input and recommendations to develop and maintain budgetary goals.


-Maintains knowledge of hospital, department, and regulatory agency policies and requirements.


-Participates in continuing education.


-STAT RN Role Specific Responsibilities:


-Assists with rapid responses and Code Blue on inpatient units.


-Assists with admissions/transfers of critically ill patients to the ICU from the Emergency Department (ED), Operating Room (OR), Post-Anesthesia Care Unit (PACU), medical/surgical or Labor and Delivery/Post-Partum units.


-Assists with care of unstable or critically ill, ICU-level patients in the ED, PACU, and medical surgical units as needed.


-Assists in IV access and phlebotomy as needed.


-Assists with patients in the Intensive Care Unit (ICU) when census/acuity exceeds core staffing and attempts to recruit additional resources have been unsuccessful.


-Assists in the transport and supervision of patients requiring diagnostic testing off a patient unit.


-All other clinical duties as assigned when there are no critical care support needs in house.


-Works under the direct supervision of the Nursing Administrator and overall direction of the nurse manager of intensive care.

Education
Other Certificate/Diploma Nursing required or Bachelor's Degree Nursing preferred

Can this role accept experience in lieu of a degree?
No

Licenses and Credentials
Registered Nurse [RN - State License] - Generic - HR Only required

Experience
Additional experience required, if any, by specialty. required and Certifications or advanced training in specialty area preferred

Knowledge, Skills and Abilities
- Strong interpersonal communication, problem solving, and conflict management skills required.
- Demonstrated clinical competence and experience as required by the specific job posting.
- Uses the nursing process and evidence based practice to ensure quality patient care is provided throughout the episode of care.
- Creates and maintains a safe and therapeutic environment for patients, self, and co-workers.
- Assures quality of nursing practice through participation in performance improvement activities.
- Ensures complete, accurate, and timely written communication of patient information.
- Provides safe, accurate, and timely medication and IV administration.
- Coordinates and collaborates with other multidisciplinary team members to facilitate a comprehensive educational plan.
- Physical Environment: The RN works in a variety of patient care environments where there may be exposure to communicable diseases and hazardous materials such as chemotherapeutic agents, radioisotopes, and radiation.
- Caring for patients also involves exposure to human waste and other unpleasant elements.
- Other duties may include general cleaning with exposure to dirt, odors, cramped quarters, etc.
- RN's may work with angry, agitated, and combative patients.

Physical Requirements

• Standing Frequently (34-66%)
• Walking Frequently (34-66%)
• Sitting Occasionally (3-33%)
• Lifting Frequently (34-66%) 35lbs+ (w/assisted device)
• Carrying Frequently (34-66%) 20lbs - 35lbs
• Pushing Occasionally (3-33%)
• Pulling Occasionally (3-33%)
• Climbing Rarely (Less than 2%)
• Balancing Frequently (34-66%)
• Stooping Occasionally (3-33%)
• Kneeling Occasionally (3-33%)
• Crouching Occasionally (3-33%)
• Crawling Rarely (Less than 2%)
• Reaching Frequently (34-66%)
• Gross Manipulation (Handling) Frequently (34-66%)
• Fine Manipulation (Fingering) Frequently (34-66%)
• Feeling Constantly (67-100%)
• Foot Use Rarely (Less than 2%)
• Vision - Far Constantly (67-100%)
• Vision - Near Constantly (67-100%)
• Talking Constantly (67-100%)
• Hearing Constantly (67-100%)

Newton-Wellesley Hospital is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment.