TRAVEL - RN - MED SURG (604) - PSL MC - 7P - 7A - BACKFILL

Travel Rn Med Surg

Unit Information: 9A Medical Surgical 60416

Location: Presbyterian St. Luke's Medical Center

Address: 1719 E 19th Avenue, Denver CO 80218

Floor: 9A

Building: A Tower

General Information

Number of Beds - 18

Number of Staff – 32

Type of staff: Day Shift – (Charge, RNs, 1 PCT) Night Shift – (Charge, RNs, 1 PCT)

Patient Ratios – 5:1 RN - Estimated ratios, not guaranteed

Type of equipment - Philips Monitors, Alaris Pumps, dopplers, welch-allyn vs machines, mobilab, glucometers

EMR - Meditech

Typical hiring profile

Skill Set Most recruited for: Travel RNs, local CNAs and sitters

Must have: candidates without these skills will not be considered for the role.

Meditech

Proficient in trachs and ostomy care

Preferred or nice to have: candidates with these skills will be considered first.

Wide experience with general surgery

List typical procedures performed on unit(s): Minimally invasive surgeries, colectomy, ostomy creation and takedown, artificial airway creation and management, podiatry and plastics

CHF, COPD, cellulitis, sepsis, DKA, PNA

Best personality fit: Team oriented, invested in good patient outcomes, upbeat and KIND

Enjoys busy environment, can shift priorities with ease. Enjoys precepting and coaching new nurses

Unit Guidelines/Policies

Must be willing to work weekend shifts

Any additional information that would entice a worker to select your unit for their assignment:

9A- Medical/ Surgical RN Agency/ Float Guidelines

Welcome to 9A! We are an 18-bed medical-surgical unit. We want your time with us to be a pleasant and rewarding experience. Each shift you work, you will have a staff nurse designated as your resource to ensure you have the necessary knowledge and tools to be successful.

Resource RN: __________________________

Please review these guidelines BEFORE the start of your shift, sign the attestation and turn in to the charge nurse. A copy will be provided for your reference throughout the shift. The guidelines contain important information about our processes and expectations. These processes are necessary to ensure we are providing high quality care to our patients and their families. If you encounter a procedure or situation associated with your assignment with which you are not comfortable, please let your charge nurse know.

Standards of Behavior

We have high standards of behavior for all members of our PSL/RMHC team, including our traveler and agency staff.

iCARE- Our standards reflect our organizational values which are known as "iCARE" values or behaviors.

I- Integrity I am honest and do what I say

C- Compassion I am sympathetic to the needs of others

A- Accountability I take ownership for how my actions and behaviors impact outcomes

R- Respect I value others and embrace diversity

E- Excellence I take personal pride in exceeding expectations

Customer Service

We want our patients to feel confident in the care we are providing and we utilize several tools to facilitate the high quality communication that supports that goal. All team members are expected to use the following:

AIDET- provides consistent structure for communicating with patients, visitors, or colleagues, on the phone and in person.

A – Acknowledge your patient by name

I – Introduce: Introduce yourself, affirming your experience/expertise.

D – Duration: Always provide a time frame and/or when you will check back in with the patient.

E – Explanation: Describe what you will be doing and why.

T – Thank you: Thank them for trusting us with their care.

No Pass Zone- Answering call lights is EVERYONE's responsibility. No one should ever pass a ringing call light or a room with an equipment alarm sounding.

Bedside Report- Shift report is performed at the bedside unless the patient requests otherwise, and includes discussion of the previous shift's events/changes in condition, the patient's plan of care, revision of goals for the day, and a review of new medications and side effects with the patient. It also includes verification of the functionality of all safety equipment, equipment settings, alarms, and iTRACE of all lines/tubing.

Purposeful Hourly Rounding – Conducted to facilitate early identification of patient needs and proactive responses. Assess the 5 "Ps": Potty, Pain, Position, Personal Items, and Pumps with each round.

Unit Specific Float/ Agency RN Checklist

Please check all boxes to indicate understanding of expectations, unit policies, and procedures. Sign the attestation at the end of this document and return to the charge RN.

Unit Routines

Shift huddles occur at 7 AM/PM. The charge RN will review important unit information. Attend on time. Get a list of door codes from the charge RN. Receive Bedside Report using SBAR report tool. Log into Responder 5 and assign your patients on your iMobile phone.

Whiteboards are used to communicate pertinent information, including the pain management plan to your patient and their family. It should be 100% complete and legible. Write your name and 4 digit phone extension. Review the board with the patient. Perform purposeful hourly rounding. Assess and respond to the "5 Ps" each hour and complete the log posted in every patient room. Make a plan with your PCT for ADLS (this is a shared RN and PCT responsibility!) Continuously check Meditech for new orders. You are responsible for acknowledging all medications ordered during your shift as well as verifying all other orders completed during your shift.

Patient Population

The patient's on med/surg are varied and range from very ill to overnight stays. We have many patients that have had abdominal surgery, GYN surgery, and also many medical patients who may be in with COPD, DM, Non-healing wounds.

GI patients-Dr. Sellers, Dr. Craig Brown, and Dr. Strutt perform colectomies, new colostomy/ ileostomy, and colostomy takedown.

Dr. Canfield performs minimally invasive general surgeries with the DaVinci Robot

GYN surgeries are usually hysterectomies with Dr. Dabelea or Dr. Forschner – vaginal or laparoscopic

Medical Teaching Patients – we have a large group of interns and residents who assist with this population

Skull base/EENT. Dr. Hepworth conducts pledget studies to rule out CSF leaks, he also repairs them. Dr. Lamond is our neurosurgeon who performs craniotomies.

Patient Care (RN Responsibilities)

Offer patients daily bed and linen changes.

Hand Hygiene: Perform before gloving, in between changing soiled/clean gloves, after patient contact, and when exiting the room.

Restraints ONLY staff who have completed the P/SL Restraint Competency may care for a patient in restraints. Reminder: Certain medications (e.g. Haldol, Ativan) may be considered CHEMICAL RESTRAINTS if ordered x1, when the goal is to decrease a patient's freedom of movement or to stop a behavior, depending upon the treatment context. If physical restraints or a potential chemical restraint is ordered, notify the charge nurse immediately, before giving/placing restraints.

Foley care is performed and documented daily. Use non-Chlorhexidine bath wipes to clean the area around the catheter entry site. Use a new CHG cloth to clean the catheter from point of insertion away from the body approximately 6 inches. Remember to document in meditech that proper foley care was provided. The drainage bag must be in a dependent position, below the level of the bladder. Do not lay the bag flat, or allow the filter to become wet. Perform hand hygiene and wear gloves before and after handling any part of the Foley catheter or drainage bag.

Central Lines Hand Hygiene: ALWAYS cleanse hands and wear gloves when doing anything with lines. SwabCaps™: place orange caps, known as alcohol impregnated caps, on all unused ports, central line lumens and access ports on the attached