Surgery

Primary Purpose: To assess, plan, implement, and evaluate the care of all patients assigned to the operating room, recovery room, and outpatient surgery, as well as to manage the supplies and equipment in the OR/RR/ASU, and to provide pre and post-op education.Formal Policy-Setting Responsibilities: Formally responsible for providing input into policies associated with the job’s purpose and essential responsibilities.Routine Decision Making: If pre-op lab and results are sufficient; surgical case schedule; if patient meets criteria for discharge from PACU/ASU.Formal Supervisory Responsibility: No formal supervisory responsibility.Unusual Working Conditions: Risk of blood, body fluid contamination.Age Specific Competencies: Provides care for birth to pediatric (birth-2 yrs.), pediatric/child patients between (2 yrs-12 yrs); adolescent patients between 12 to 18 years of age; adult patients between 18 to 64 years; and geriatric patients 65 years and older.Essential Responsibilities and TasksAssesses, Plans, implements and evaluates patients receiving high risk specialty procedures. (40% of time)Performs pre-procedure interviews per paper/computer correctly on all patients, evaluates the information obtained, and formulates a plan of care prior to the patient procedure.Identifies the patients using two patient identifiers prior to the procedure 100% of the time.Performs a comprehensive nursing assessment on patients and documents completely including appropriate signatures, times and dates. Revises plan of care as indicated from the assessment.Interprets physiological information from technical equipment, on each patient and applies this information to the plan of care.Documents the findings from all assessments, evaluations and implementations on the patient record where, when, and how daily.Reports all critical abnormal assessments and lab values to the physician, per hospital policy and implements further orders immediately and documents details on the patient record.Adequately assess and reassess pain. Utilizes appropriate pain management techniques. Educates the patient and family regarding pain management.Utilizes AIDET (acknowledge, introduce, duration, explain and thank) initiatives to include managing up with each patient.Utilizes only approved abbreviations in patient documentation.Provides patient education. (15% of time)Provides pre-operative and post-operative teaching to all patients.Evaluates patient learning ability and motivational levels. Implements alternative learning measures, as evidenced by patient or caregiver verbalization or return demonstrations, as documented on the patient record i.e.; effectively communicates.Effectively communicates discharge instructions to patient and responsible party at the time of discharge, per departmental discharge policy.Explains all procedures and medications to patients prior to implementation.Maintains a safe and comfortable environment. (25% of time)Removes malfunctioning equipment from unit immediately upon discovering problem.Complete requisition for repair or malfunctioning equipment by the end of shift.Cleans and stocks supplies within the department, as needed.Effectively communicates the plan of care on each patient to ancillary departments, case management and pharmacy staff as indicated by the orders received, patient diagnosis or condition.Ensures all required documents are on the chart prior to going into the procedure room (H&P, informed consent, test results if applicable).Evaluates the effectiveness of the communication, as evidenced by the preparedness of the patient and takes appropriate actions, including notifying performing physician.Demonstrates thorough knowledge of location, care and operation of all departmental equipment.Accurately records, handles and labels specimens; demonstrates care of specimens.Ensures alarms on any assigned area are audible to alert staff.Assists with the cleaning and care of surgical instrument.Assists with terminally cleaning of OR rooms and documents on cleaning schedule.Positions patients on operating table to facilitate surgical approach and to ensure patient safety for each case.Uses padding on any boney prominences for each patient and documents on operating room record.Applies cautery pads on muscular areas close to surgical site and away from any implants on each patient and documents on record.Applies safety belt to each patient having surgery and documents on record.Checks code blue carts each shift and upon using the cart, ensuring it has an intact tag attached.If assigned as the scrub nurse, is fully responsible for care of instruments prior to, during and after the surgical case including appropriate transporting to decontamination.Follows manufactures instructions for the sterilization equipment; knows responsibilities and the necessity for biological/chemical monitoring.Able to accurately see and read color changes to biological and chemical monitors.Demonstrates utilization of the nursing process through planning for patient care. (10% of the time)Pulls supplies for next day’s cases daily from departmental supplies according to physicians’ preference cards.Orders special equipment as requested by physician or on preference card to have prior to surgery start time.Updates preference cards to meet physician’s preferences so surgeon does not need to ask more than once.Develops and promotes hospital/unit initiatives and professional relations. (5% of the time)Establishes and maintains effective communication and good working relationship with co-workers for the patients benefit.Utilizes initiatives; strives to maintain steady level of productivity; self-motivated; manages activity and time; does not waste.Participates in planning ways to solve problems and make improvements in the department as needed.Represents the organization in a positive and professional manner.Other duties as directed. (5% of the time)ESSENTIAL PHYSICAL REQUIREMENTSHeavy Work: Lifting 100# maximum with frequent lifting and/or carrying of objects weighing up to 50#.PHYSICAL DEMANDSLifting: Raising or lowering an object from one level to another (includes upward pulling).Carrying: Transporting an object, usually holding it in hands or arms or on the shoulders.Pushing: Exerting force upon an object so that the object moves away from the force (including slapping, striking, kicking, and treadle actions).Pulling: Exerting force upon an object so that the object moves toward the force (includes jerking).Hearing: Ability to determine audible communication.Stooping: Bending the body downward and forward by bending the spine at the waist.Kneeling: Bending the legs at the knees to come to rest on the knee or knees.Crouching: Bending the body downward and forward by bending the legs and spine.Crawling: Moving about on the hands and knees or hands and feet.Reaching: Extending the hands and arms in any direction.Handling: Seizing, holding, grasping, turning, or otherwise working with the hand or hands (fingering not involved).Fingering: Picking, pinching, or otherwise working with the fingers primarily (rather than with the whole hand or arms as in handling).Feeling: Perceiving such attributes of objects and materials as size, shape, temperature, or texture by means of receptors in the skin, particularly those of the finger tips.Speaking: Expressing or exchanging ideas by means of the spoken word. Those activities in which they must convey detailed or important spoken instructions to other workers accurately, loudly, or quickly.Seeing: Obtaining impressions through the eyes of the shape, size, distance, motion, color or other characteristics of objects.Acuity, near - clarity of vision at 20 inches or less.Depth perception - ability to judge distance and space relationships so as to see objects where and as they actually are.Field of vision - area seen up and down or to the right or left while eyes are fixed.Accommodations - adjustment of the lens of the eye to bring an object into sharp focus.Color vision- the ability to identify and distinguish colors.WORKING CONDITIONSInside: Worker spends approximately 75% or more of time inside.Wet: Contact with water or other liquids.Noise and Vibration: Sufficient noise, either constant or intermittent to cause marked distraction or possible injury to the sense of hearing and /or sufficient vibration (production of an oscillating movement or strain on the body or its extremities from motion or shock) to cause bodily harm if endured day after day.Hazards: Situations in which the individual is exposed to the definite risk of the bodily injury.Fumes: Smoky or vaporous exhalations, usually odorous, thrown off as the result of combustion or chemical reaction.Odor: Noxious smells, either toxic dust, fumes, gases, vapors, mists or liquids which cause general or localized disabling conditions as a result of inhalation or action to the skin.Education and Certification/ Registration required for the Position: Two to four-year RN degree; currently licensed in the state of Missouri; ACLS/BLS required; PALS preferred.Required Knowledge: A&P; disease process; sterile technique; standards set by Association of Operating Room Nurses Association (AORN); functions and mechanism of multiple operating room equipment.Required Skills and Ability: Computer skills; good communication skills; good organizational skills. #J-18808-Ljbffr Cass Regional Medical Center