Registered Nurse - ED - Part Time -Nights 7 pm -7:30 am Monday thru Friday & every 3rd weekend

Emergency Room Registered Nurse

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. Help to alleviate patient fears and anxiety through skillful application of professional and interpersonal communication. Utilize a variety of pharmacologic and non-pharmacologic approaches to ensure patient comfort and relief of pain. Involves patient, family, significant others in development of plan of care.

Collaborate with patient/family, hospital staff, and community agencies to develop discharge plans that prepare patients for continued care needs. 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).

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.

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.

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 patients pain on admission, after pain producing events, with each new report of pain, and routinely at regular intervals.

Inform 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.

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.) 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 4 Ps (patient, pertinent issues, picture, plan) to give appropriate and pertinent information at change-of-shift and/or transfer.

Participate in the creation and maintenance of a healthy work environment by: Treating co-workers with respect. Communicating to co-workers with respect; resolving conflicts and/or negative feelings promptly, privately, and appropriately. Taking responsibility for personal actions, behaviors, and attitudes and not displacing anger or frustration onto co-workers, patients, or families. Communicating appropriate patient care issues/concerns to nurse manager. Respond appropriately to changes in unit workloads, patient census, and/or staffing levels. Interpersonal skills necessary in order to interact with patients/families, other nursing staff members, physicians, and other hospital personnel. Ability to concentrate and pay close attention to detail when planning and performing professional nursing care, resolving patient care problems, and dealing with patients and families; often during stressful situations. Ability to walk or stand continuously and frequently lift and position patients. Working Conditions: Normal patient care environment with moderate exposure to excessive noise, dust, temperature, etc. Frequent exposure to communicable diseases, hazardous substances, and moderately adverse Working Conditions due to performance of patient care activities.

Orientation Requirements: This position, aside from the above requirements, will require approximately three (3) to nine (9) months on-the-job experience in order to acquire and effectively apply knowledge of unit and departmental policies, procedures, and standards for patient care and professional nursing practice. The most recently dated job description on file in the Human Resources Department will be considered the official job description.

Education/Experience Requirements

• Licensed Registered Nurse credentialed from the Michigan Board of Nursing obtained within 2 Months (60 days) of hire date or job transfer date required.
• Certified BLS Provider specializing in Basic Life Support credentialed from the American Heart Association (AHA) obtained within 3 Months (90 days) of hire date or job transfer date required. Or Certified Instructor.
• Requires a graduate of an approved professional (RN) nursing program
• One year minimum nursing experience (ER preferred)