Registered Nurse- Emergency Department

Registered Nurse

Responsible for the provision of basic nursing care to assigned patients in accordance with current FMC Standards of Care. Administers and monitors therapeutic interventions proficiently. Demonstrates proficiency in applying the nursing process to assigned patients and families. Assumes accountability for the outcomes of nursing care. Collaborates with health team members, patients/families in the provision of care. Provides direct supervision to other health team members in the implementation of the patient care plan. Effectively delegates care to peers, Licensed Practical Nurses, Nursing Assistants, Orderlies and other direct care givers consistent with their level of education and expertise. Acts as an advocate for patients/families/significant others. Assumes accountability for own professional practice and for aspects of nursing care delegated to others. Practices within accepted ethical and legal parameters of nursing. This description covers the essential functions of the position.

Provides age-appropriate care to patients. Demonstrates knowledge of developmental stages for the following age groups and applies developmental theories and concepts when planning and implementing care for patients.

For each assigned patient, the nurse will proficiently perform a comprehensive nursing assessment and use professional judgment to obtain selective data to arrive at nursing diagnoses and discharge planning needs. The nurse will perform a systematic comprehensive assessment of the health needs of all assigned patients 100% of the time. Ensures that all assigned patients have a completed admission profile, health database/patient history. Elicits relevant selective data for a comprehensive nursing history, incorporating patient strengths and limitations. Integrates a variety of methods to collect relevant patient data, (e.g., nursing history, observation, examination, communication with colleagues and chart review) to formulate realistic nursing diagnoses. Anticipates appropriate health care needs beyond acute care setting.

Performs a proficient ongoing assessment of assigned patients recognizing subtle changes in health status 100% of time. Recognizes changes that require immediate intervention. Anticipates consistently predictable changes in patient status. Determines frequency of observation based on an ongoing assessment. Furnishes physician and appropriate health team members with pertinent assessment data. Documents pertinent assessment data in a clear and concise manner.

For each assigned patient, the nurse will formulate a detailed, realistic plan of care specific to each patient's identified needs. Develops and updates a realistic plan of care with measurable and achievable goals 100% of time. Upon identification of an actual or potential problem, the nurse promptly initiates a plan of care and updates per unit specific guidelines. Reassesses priorities and makes appropriate changes in plan of care with patient/family's input. Formulates realistic and attainable goals appropriate to the hospital setting and discharge needs.

Analyzes the psycho-social impact of illness & hospitalization on individuals and families 100% of the time Collaborates and negotiates with patients and families to arrive at an agreed upon plan of care. utilizes and communicates with physicians and interdisciplinary team members to establish goals. Incorporates psycho-social, spiritual and cultural needs into plan of care.

For each assigned patient the nurse will proficiently implement the individualized plan of care. Demonstrates proficiency in clinical nursing skills 100% of the time. Independently organizes own assignment and prioritizes plan of care accurately. Delegates aspects of care to other personnel consistent with job description and skill 100% of the time. Consistently initiates interventions to maintain a safe and therapeutic environment 100% of the time as evidenced by an absence of preventable incidents. Anticipates outcomes of physician orders and nursing actions and seeks explanation when in question. Demonstrates flexibility in care without deviating from FMC standards, procedures or policies. Responds consistently, to urgent and life-threatening situations with appropriate actions.

Provides formal and informal teaching relevant to health care needs of patients utilizing available resources 100% of the time. Ensures patients/families are informed concerning treatments, procedures and hospital policies and routines. Documents each phase of the learning process, reinforcing teaching and implementing change as needed. Considers patient/family's level of knowledge and readiness to learn.

Effectively implements and revises the discharge plan 100% of the time. Initiates interdisciplinary discharge plan at time of admission. Completes appropriate discharge/transfer form and documents accordingly. Prepares patient/family for the changes in the health care delivery system.

For each assigned patient the nurse will establish a pattern of ongoing evaluation and modification of patient care interventions while demonstrating accountability and responsibility for professional nursing practice. Evaluates and modifies patient plan of care on a continuing basis 100% of the time. Observes patient responses to treatment, illnesses and hospitalization and compares the expected with the actual outcomes. Documents present status and notes significant alterations from anticipated status. Utilizes available resources to assist in the evaluation process.

Accurately determines the effectiveness of his/her nursing care 100% of the time. Evaluates whether selected nursing interventions were appropriate to reach set goals. Uses patient outcomes to evaluate effectiveness of nursing interventions. Continually re-evaluates strengths and weaknesses for accountability of nursing care. Demonstrates credibility and honesty in nursing practice.

Accurately and concisely communicates pertinent patient information while maintaining confidentiality 100% of the time. Documents patient care and patient responses promptly, clearly and thoroughly on appropriate forms. Understands and utilizes professional hierarchy in problem solving related to significant changes in patient status and documents appropriately. Communicates pertinent patient information in a concise manner through shift to shift report and intra-hospital transfer. Maintains a patient's right to privacy and confidentiality.

Acts as an advocate for patient families 100% of the time. Acts as a representative in communicating patient/family's needs to physicians and other health care team members. Understands and supports Franklin Medical Center's "Patients' Bill of Rights." Intervenes consistently, in situations where patient integrity is threatened. Supports and encourages patient/family's decisions maintaining respect for life and dignity.

Will assume accountability for management of patient care and will provide direct supervision to other health team members. Demonstrates behaviors that will promote effective management of patient care 100% of the time. Develops and evaluates patient care assignments, considering the patient needs and capability of the nursing personnel. Promotes cost containment by utilizing human and material resources efficiently. Provides constructive feedback regarding performance of peers to unit supervisor/designated individuals. Consistently initiates incident reports when indicated and provides information for timely follow-up. Orients to charge role and acts as alternate charge nurse as designated.

Will demonstrate proficiency in applying the principles of teaching/learning to patient/family & with minimal assistance identify own professional educational needs. Assesses each patient/family's comprehensive learning needs in relation to health and illness 100% of the time. Individualizes standardized teaching plans to meet specific needs of patient/family. Participates in patient care conferences (discharge planning) and communicates critical information at change of shift report.

Identifies own professional educational needs with minimal guidance 100% of the time. Performs a realistic self evaluation to determine own strengths and weaknesses. Orients to preceptor role. Consistently supports the growth and development of students and new personnel. Attends continuing education programs (5-8 contact hours or equivalent) related to the achievement of own professional goals as evidenced by self report with appropriate documentation. Is a member of unit-based committee, task force or change producing group. Attends and participates in 80-90% of Unit Staff meetings as evidenced by attendance roster/review of minutes. Demonstrates ability to develop a therapeutic relationship with patients, families and other members of the health care team. Promotes collaboration/team building and healthy interpersonal relationships with others.

Will promote active participation in quality assurance research activities of health team members within realm of responsibility. Demonstrates active participation in quality assurance/research activities 100% of the time. Identifies 1-2 patients and/or nursing problems that need to be systematically investigated as evidenced by committee reports and/or evaluation/research tools. Communicates consistently with colleagues about quality assurance/research findings and their relevance to nursing practice. Participates in and ensures follow-through of research/quality assurance data collection. Is able to state current Unit CQI initiatives. Communicates an attitude of positive customer focused interactions in daily work activities.

Required Work Experience: None

Preferred Work Experience: Minimum of 1 year of nursing experience

Skills and Competencies: Evidence of a commitment to professional growth through participation in continuing education

Department Certification Requirements

• MHU - CPI within 30 days of hire
• Oncology - Oncology certification required within 2 years of hire
• Quality – no required certifications
• Cardiopulmonary – ACLS required by end of orientation
• ICU and Med/Surg - ACLS required by end of orientation
• OB – NRP and ACLS required by the end of orientation
• Surgical Services - ACLS and PALS required by the end of orientation
• ED - ACLS, PALS, and CPI by the end of orientation

Education: Diploma in