Registered Nurse/PCU

Job Description

Job Description

### RTO after booking is NOT allowed and is NOT allowed to be worked out onsite. Any call-offs or additional RTO on unit, could possibly turn into a Cancel and DNR ###

REQUIRED SKILLS / CERTS / EXP:
Minimum Years of Experience: 2 Years Experience REQUIRED
Traveler Experience: Unit WILL NOT Accept 1st Time Travelers
Locals Accepted / Rate Difference: Yes
Skills: Telemetry, IV Starts, Interpretation of dysrhythmias, Management of dysrhythmias, Peripheral Line Care/Management, Non-invasive airway management, Post cardiac Cath Experience and post cardiac/vasular surgical experience
Certs: ACLS, BLS, NIH

PREFERRED SKILLS / CERTS / EXP:
Skills: Charge Nurse Experience, Wound Care/Wound Vac
Certs: NIHSS

JOB DETAILS:
-RATIOS: The Intermediate ICU is a very fast paced unit. The nurse patient ratio is 4:1. Avg. Daily Census: 24, 24 Rooms/24 Beds
***Unit will accept 20-week contracts to get the Unit through the Holidays!
-SHIFT: *36 or 48 hours.
-12 HR NIGHTS; 18:45 - 07:15
***RTO: 7 days MAX for Aya Auto Offer***
-Float Requirement: **Some floating required to our Cardiac Telemetry unit and Patient Ratios can run up to 1:6 in a Med Surg assignment**
-Weekend Requirement: Every other weekend.

PATIENT DIAGNOSES: The Intermediate Intensive Care unit is a twenty four bed unit that provides 24 hour (7 days a week) nursing observation, monitoring, and intervention to patients with medical/surgical, cardiac, renal, bariatric surgery, pulmonary, and trauma related disease processes.

SCOPE OF CARE/SERVICE:
**A. The patient population on 5A PCTU is predominately adult,(18-65 years) and Geriatric (65 years and over) with diverse backgrounds.
**B. Patients appropriate for admission/transfer to this unit must require cardiac telemetry monitoring. Primary focus on this unit is heart failure and postprocedural patients.
**C. Priority for admission/referral is given to patients with primary diagnosis/conditions including:
1. Acutely decompensated heart failure
2. New onset heart failure
3. Patients pre and/or post cardiac, peripheral or renal interventional procedure (ie: PTCA, Coronary Atherectomy, Roto blader, Angio-jet Coronary Artery Stent, PTA, PFO closure) with or without arterial/venous sheath(s) in place.
4. Patients pre and/or post procedures done in the Electrophysiology lab pacemaker implantation, pacemaker battery change (if not discharged home), electrophysiology studies, implanted cardioverter/defibrillators, and ablations
5. Acute coronary syndrome.
6. Active chest pain with nitroglycerin (where future cath can be anticipated).
7. Pericardial drains and chest tubes
8. Trans venous Pacemakers only through an Internal Jugular site with an underlying rhythm.
9. Telemetry monitoring
10. Patients requiring intermediate assessment, monitoring, or intervention for medical and/or surgical conditions
11. Patients on insulin drips (No DKA protocol)
12. Titration of certain vasoactive intravenous medications (see medication by location policy)
13. Cardioversions are performed on the unit with the cardiologist and anesthesia in attendance.
14. High risk pre-PCI or high risk pre-open heart surgical patients.
15. Stable post STEMI patients
16. Arterial and venous sheaths, either transduced or to be pulled.
17. Stable Post- op immediately after recovery Transcatheter Aortic Valve Replacement (TAVR)
18. Patients on high flow nasal cannula, continuous Bi-pap, and Opti-flow
19. Patients who have received a watchman device.
20. Patients who have received a Mitral Clip D. PCTU works in collaboration with the outpatient heart failure clinic to provide comprehensive evidence-based disease management of adults diagnosed with advanced chronic heart failure. PCTU provides inpatient care, patient and staff education, outpatient referral, end of life care for the HF patient in conjunction with its relationship to the Heart Failure Program.

SPECIAL PROCEDURES / UNIT DETAILS: The criteria for admission includes, but is not limited to, patients requiring the
following:
1. Frequent VS and respiratory monitoring via Mechanical ventilation
2. BiPAP or CPAP
3. Continuous or < q 2h nebulizer treatments
4. Vasoactive IV medications as outlined per policy
5. Continuous ECG monitoring
6. Pediatric patients < 16 years are not admitted to the Intermediate Intensive Care unit.

The care of the patients may include, but is not limited to, the following diagnostic modalities or therapies:
1. Continuous EKG monitoring
2. Non-invasive pressure monitoring
3. EEG Monitoring
4. Continuous pulse oximetry monitoring
5. Elective or emergent cardioversion (with Cardiologist and anesthesia present)
6. Administration of medications including weaning of intravenous vasoactive drugs
7. Oxygen therapy
8. Pre and post care for diagnostic and therapeutic procedures
9. Provision of emotional support to patient/family/significant other
10. Education for patient /family/significant other
11. Nutritional therapy
12. Emergency assistive procedures for patients experiencing cardiac/respiratory arrest within the unit and/or hospital as designated in Code Blue policy
13. Wound care
14. Safety management.

UNIT SYSTEMS: PYXIS, Epic Product Dimensions, SBAR

SCHEDULING TYPE: Self-Scheduling based on Unit Needs

UNIT ORIENTATION: 36 Hours on Unit

SCRUBS: Any Combo of Navy and White

*** INTERNAL NOTES ***
***Must pass EKG Testing prior to start for, this specialty***