Registered Nurse - Observation Unit - Full-time, Nights, 7pm-7:30am, every 3rd weekend

Registered Nurse

Nursing at Henry Ford Health Genesys Hospital

Requisition #: 268692

New Premiums:

• 5% Market Pay Differential
• Increased Night Shift Premium - 10%
• $2 Weekend Differential

Sign On Bonus: $10,000

Department: Observation Unit

Schedule: Full Time, Nights, 36 hours per week, 7pm-7:30am weekdays and every third weekend

Hospital: Henry Ford Health Genesys

Location: Grand Blanc, Michigan

General Summary:

• Use independent professional judgment, analytical skills, and the nursing process to provide a full range of delegated, interdependent, and independent nursing services to patients.
• Within the framework of the Seven Dimensions of Patient Care and Benner's Domains of Nursing Practice, demonstrate clinical competence; compassion and customer service orientation; focus on process and outcomes; and cost-consciousness when assessing, planning, implementing, and evaluating nursing care provided to patients.
• Provide patient care that reflects a respect for patient's rights, dignity, values, culture, preferences, and expressed needs. Assesses patient/family needs for information and education across the continuum, plans and implements patient teaching using a variety of techniques and methods, and evaluates effectiveness of educational interventions.
• Collaborate with patient/family, hospital staff, and community agencies to develop discharge plans that prepare patients for continued care needs.
• Orientation Self-Evaluation: (C) Competent (NT) Needs Training or Review. - Standards of Performance: - Seven Domains of Nursing Practice. - Helping/Teaching &Coaching: - Incorporate all elements of Signature Care in Daily interactions with patient: - Introduce self and writes name on whiteboard. - Discuss plan of care with patient/family. - Explain meds and treatments, provide teaching as appropriate. - Ask if patient needs anything else before leaving room. - Assess health status and determines care needs of the patient. Performs ongoing reassessment as required. - Complete Admission Assessment and shift assessment as required.
• Complete assessment for Risk Factors; including fall, skin breakdown, VTE, and aspiration. Initiate appropriate initiatives as indicated SKINN Bundle, Fall Prevention Plan, SCD, etc. - Complete Medication Reconciliation upon admission and change in level of care. - Establish, direct, coordinate and document plan of nursing care in conjunction with patient/family.
• Initiate Problems and Outcomes list (plan-of-care) based on medical diagnosis and patient needs.
• Monitor, document, and report patient response to interventions and progress toward outcomes.
• Document nursing interventions (NIC) and progress toward outcomes (NOC); patient education; and evaluation every shift, as required.
• Educate patient regarding treatment plan, safety measures, medications, and self-care as indicated. Document education activities on shift assessment flowsheet and plan of care (POC). - Work with Case Manager to ensure appropriate referrals initiated prior to discharge.
• Review discharge plans/instructions with patient prior to discharge, including signs/symptoms to watch for after leaving the hospital. Ensures appropriate follow-up arranged.
• Ensure that core measures Discharge Instructions are given to all CHF patients.
• Document patient care according to established documentation guidelines.
• Administration of Therapeutic Regimens:
• Demonstrate knowledge and skill application of basic nursing procedures - dressing change, catheterization, NG tube insertion, suctioning.
• Implement/complete medical interventions as ordered. Initiate standing orders appropriately. Initiate and/or assists with all patient care activities including activities of daily living and provides other services as required for patient comfort, safety, and well-being.
• Assess and initiate interventions to prevent/minimize patient skin breakdown.
• Follow clinical practice guidelines and procedures as written.
• Establish and maintain peripheral IV therapy.
• Obtain body fluid specimens, per procedure.
• Obtains blood specimens if no phlebotomist assigned to area.
• Perform blood capillary glucose monitoring.
• Administer the following according to established policies and procedures: - Medications. - IVs. - Blood products.
• Prepare patients for surgery or other invasive procedures according to established guidelines.
• Perform or assist with procedures according to established standards of care and nursing practice.
• Utilize equipment based on manufacturers instructions and established nursing procedure. Correctly operates and trouble shoots IV pumps, PCA pumps, epidural pumps, feeding pumps, patient beds, as applicable.
• Monitoring Patient Responses/Responding to Changing Patient Situations.
• Regularly reviews work in progress to ensure that treatments, medications, and tests ordered are expeditiously carried out and documented.
• Review patient medical record/reports and confers with physician regarding treatment plans. Routinely checks chart for new orders.
• Monitor patient physiologic parameters including vital signs, lab work, I&O, blood glucose; recognizes and reports meaningful changes and intervenes appropriately. Documents interventions accordingly.
• Monitor presence and intensity of patient s pain on admission, after pain producing events, with each new report of pain, and routinely at regular intervals.
• Informs patient about pain relief and pain relief measures; administers pain medication or alternative interventions as indicated; includes pain management resources in the discharge plan/instructions.
• Recognize acute changes in respiratory status - dyspnea, cyanosis, tachypnea, respiratory depression, airway obstruction and responds - appropriately with direct intervention and physician/SWAT notification.
• Recognize acute changes in neurologic status/decreased LOC and responds appropriately with direct intervention and physician/SWAT notification.
• Recognize acute changes in cardiac status - tachycardia, chest pain and responds appropriately with direct intervention and physician/SWAT notification.
• Recognize acute changes in urinary output and responds appropriately with direct action and physician notification. - Utilize SBAR tool or other standardized approach to data collection and information sharing when notifying physician of patient changes/concerns.
• Respond appropriately to life-threatening emergencies through initiation of CPR, assembly of emergency equipment, and immediate interventions (as allowable and indicated).
• Perform emergency equipment checks.
• Provide appropriate support/summons appropriate resources for families in crisis/grieving process. Ensuring Quality of Health Care Practices.
• Communicate with other professionals/departments and physician staff to ensure appropriate progress of patients through the system.
• Monitor individual patient length of stay (LOS); notifies case manager and nurse manager of potential LOS/discharge issues.
• Identify ethical issues related to patient care (including issues related to advanced directives) and initiates steps for resolution. -
• Demonstrate adherence to patient confidentiality requirements.
• Communicate with patients and families cordially, diplomatically and respectfully.
• Act to resolve customer concerns/complaints immediately; reports complaints that cannot be immediately resolved to Patient Care Director, Clinical Manager, or House Supervisor.
• Promote a physically safe environment for the patient including use and documentation of restraints according to policy.
• Utilize universal precautions for all patients.
• Make cost effective use of supplies and resources.
• Assist in evaluating new products, procedures, nursing practices.
• Support organizational, nursing department, and unit strategic goals and activities; participates in department and unit based council/staff activities meetings.
• Support and actively participate in Nursing Department and unit specific quality monitoring and quality improvement activities.
• Participate in teaching/mentoring of student nurses and orientates.
• Evaluate own performance utilizing input from peers, co-workers, managers, physicians, customers, and develops a plan for continual improvement. (Does not include formal peer review.).
• Complete yearly safety and unit specific education requirements (GLI).
• Organizational and Work Role: - Provide input on appropriate patient care assignments; taking into consideration patient condition and knowledge/experience/work load of staff.
• Provide direction and leadership to other staff by: - Clearly communicating expectations/responsibilities to team members. - Observing patients and work in progress periodically throughout the shift.
• Communicating with team members about work to be completed/problems encountered.
• Assisting team members with patient care activities as needed.
• Assisting other "teams" as situation requires.
• Use the