Registered Nurse - Ambulatory Surgery Center

The Registered Nurse ASC is expected to work in a primary nursing area for the center. The Registered Nurse ASC is able to function as a team member in an ASC environment through cross-training to other primary areas including but not limited to assisting with turnover, and all other aspects of day-to-day ASC operations. He/she is also responsible for the coordination of the telephone pre-admission assessment process for patients in the ASC environment.

• Education: 
• 2 Year / Associate Degree, required. Graduate of an accredited school of nursing
• 4 Year / Bachelors Degree, preferred.
• Experience:  One year of ASC, PACU or operating room experience, preferred.
• Licensure/Certification:
• Current RN licensure in appropriate state, required.
• ACLS and PALS, preferred.
• Additional Skills (required):  Must have a thorough understanding of role of RN and ability to carry out the functions as stated in the NC nurse practice act. Ability to set priorities and organize workload of unit. Has knowledge and skills necessary to modify care according to patient’s age. Has the ability to interpret information to identify each patient’s requirements for care relative to his/her age specific needs. Proficient in telephone screening and interviewing skills.

Philosophy

• Supports the facility’s ideology, mission, goals, and objectives.

• Performs in accordance with the facility’s policies and procedures.

• Follows the facility’s standards for ethical business conduct.

• Conducts self as a positive role model and team member.

• Recognizes patients’ rights and responsibilities and supports them in performance of job duties.

• Participates in facility committees, meetings, in-services, and activities.

Communication

• Communicates effectively and professionally with patients, visitors, physicians, and coworkers.

• Interacts with others in a positive, respectful, and considerate manner.

• Answers the phone as needed throughout the center.

Financial Practice

• Uses facility resources appropriately and avoids wasteful practices.

• Reports and acts on wasteful practices.

• Analyzes work area and makes recommendations for potential cost-effective improvements.

Compliance

• Contributes to the progress and development of the organization’s adopted compliance program.

• Performs according to established compliance policies and procedures.

Performance Improvement Program

• Contributes to the progress and development of the organization's adopted performance-improvement program.

• Performs according to established performance-improvement policies and procedures.

• Objectively evaluates suggestions, grievances, and processes to identify opportunities to improve performance and quality of care.

• Participates in data collection activities to support the performance-improvement program.

• Assists as requested in performance improvement by the ASC Administrator or Clinical Coordinator.

Safety Risk Management Program

• Adheres to safety policies and procedures in performing job duties and responsibilities.

• Reports observed or suspected safety violations, hazards, and policy/procedure noncompliance to safety officer or other designated person.

• Actively involved in ensuring that the First Do No Harm program is successful for the center.

Professional Competence

• Participates in continuing education and other learning experiences.

• Shares knowledge gained in continuing education with staff.

• Maintains membership in relevant professional organizations.

• Seeks new learning experiences by accepting challenging opportunities and responsibilities.

• Welcomes suggestions and recommendations.

Duties for all RNs

• Participates as a team member in support of the total surgical experience for the patient.

• Effectively organizes time, equipment, supplies, and personnel for management for the nursing units.

• Organizes nursing activities efficiently, considering staff abilities when delegating activities.

• Uses equipment effectively by anticipating patient needs and providing appropriate care.

• Organizes time, equipment, supplies, and personnel to provide effective and efficient case management.

• Confirms that proper techniques and procedures are used according to accepted standards of practice such as AORN and ASPAN.

• Assists in managing inventory of supplies, drugs, and equipment to maintain availability and stock levels in the pre, peri and postoperative areas.

• Maintains order and cleanliness of all nursing areas.

• Transports patients to nursing areas for care as appropriate observing policies/procedures, safety requirements, and patient needs.

• Reviews the patients’ medical records/needs to plan care with other healthcare team members.

• Provides comfort and reassurance to patients.

• Maintains patients’ privacy, confidentiality and dignity.

• Provides comfort and reassurance to the patient.

• Accurately comprehends and interprets verbal orders/directions.

• Documents patient care records and other forms accurately and timely following policies and procedures, ensuring that the medical records are complete each day.

• Accurately advises others responsible for care of the patient about patient’s status.

• Performs safe and individualized nursing care for the patient.

• Ensures that safe medication practices are adhered to.

• Takes ownership in checking crash carts, malignant hyperthermia carts, hygrometers, expirations of supplies and medications, and temperature monitors throughout the center as required by policy and procedure.

Duties for Primary Areas Preoperative

• Performs thorough preoperative patient assessment required in the outpatient setting.

• Assists in assessing the physical and emotional status of the patient prior to admission.

• Provides preoperative instruction and explanation of patient rights and responsibilities.

• Describes the perioperative experience to the patient/significant other, including what to expect before, during, and after the procedures, and how the significant other will participate.

• Obtains pertinent patient records prior to patient’s arrival for preoperative testing.

• Performs assigned preoperative testing such as lab draws, electrocardiogram, etc.

• Reports all abnormal values to anesthesia/attending surgeon.

• Ensures that all necessary medical clearances are in place and complete.

• Explains informed consent for surgery, patients’ rights/responsibilities, and preoperative/postoperative instructions.

• Obtains necessary signatures.

• Informs patient about routine care and procedures related to the perioperative experience.

• Discusses all findings with anesthesia prior to anesthesia’s preoperative evaluation of the patient.

• Ensures that patient’s chart is complete the day before the surgery/procedure is schedule.

• Maintains and updates all physician order sets.

Duties for Primary Areas Pre-Op and PACU

• Assesses and documents the patient’s physical and emotional status upon arrival in the Pre-Op and PACU.

• Documents post-anesthesia care and identity of second person in the Pre-Op and PACU during the patient’s recovery from anesthesia/sedation according to approved policies and procedures.

• Provides nursing care to meet patient needs related to surgical condition and type of anesthesia administered.

• Monitors patients and informs surgeon or anesthetist of observed complications.

• Performs thorough postoperative patient assessment prior to discharge of the patient.

• Assists in assessing the physical and emotional status of the patient in preparation for discharge.

• Develops a plan of care for the patient based on the assessment data.

• Reviews postoperative instructions and prescriptions from the surgeon with patient and significant other and documents in the patient’s medical record.

• Informs patient and family about appropriate care and procedure to follow upon returning home.

• Determines that patient and significant other understand conditions that require immediate care/method to obtain immediate care.

• Maintains and updates all physician order sets.

Duties for Primary Areas OR and Procedure Room

• Supervises and directs patient care in a single operating room.

• Organizes nursing activities efficiently and effectively.

• Participates as a team member in support of the total perioperative process.

• Considers cost containment by using supplies economically and in effective turnover time.

• Ensures that supply, drug, instrument and equipment inventories are maintained and available for procedures and surgeries.

• Addresses patient needs during admission to the operating room, with attention to requirements specific to the outpatient setting.

• Identifies the patient and correct surgical intervention according to policy/procedure and communicates such information to all members of the surgical team.

• Explains intra-operative phase of routine procedures and care to the patient.

• Performs the circulating nurse’s role and functions following approved operating room procedures to meet the requirements of scheduled procedures.

• Prepares operating/procedure room according to requirements of patient/procedure to be performed.

• Assembles and provides properly functioning equipment, supplies, and instruments before start of procedures and positions and adjusts equipment as required during the procedure.

• Anticipates the needs of the surgical/procedural team and assists anesthesia personnel by supporting patient during administration of anesthesia.

• Assists with the proper and safe positioning of the patient and prepares operative site as directed by established procedures.

• Monitors compliance with principles of aseptic technique according to accepted standards.

• Assists with the identification and confirmation of operative site.

• Provides for comfort in the physical environment by monitoring designated parameters.

• Provides continuity of patient care by communicating with other perioperative care personnel and documenting records accordingly.

• Responds in a timely manner to meet the needs of the patient and physician.

• Maintains and updates physician preference cards/lists, adhering to safe, efficient and effective practices for the center.

Duties for Primary Areas Sterile Processing

• Works with the infection prevention nurse/practitioner regarding practices for sterile processing.

• Maintains a clean and orderly central processing area—shelves, counters, equipment, etc.

• Adheres to sterilization process policies and procedures.

• Cleans, disinfects and sterilizes each item according to manufacturer’s instructions and guidelines.

• Sorts and arranges items into proper trays according to established policy/procedure.

• Accurately labels each item with name and expiration date.

• Correctly operates sterilizers, ultrasonic washer, and other processing equipment—positions items correctly in sterilizer or washer, selects proper cycle, seeks assistance when needed.

• Checks equipment indicators for proper functioning.

• Performs required biological/chemical monitoring tests on all sterilizers and maintains logs according to established policy/procedure.

• Maintains availability of recording supplies for continuity of recording throughout sterilization process.

• Maintains inventory levels and accurate records.

• Performs weekly inspections of all sterile items in facility.

• Checks for outdated items and package integrity of wrapped sterilized items; replaces items as necessary.

• Places items in correct location.

• Maintains adequate inventory of supplies for the sterile processing area.

• Maintains/updates the instrument tray inventory list.

• Accurately documents count of instruments loaned/returned to outside sources.

Responsibility or Assets

• The ASC RN is responsible for instruments, equipment, medical records, logs, associated compliance documents for the nursing units, medications, supplies, facility cleanliness and security.