Registered Nurse - Per Diem - Primary Care

Registered Nurse

This role focuses on providing professional and nonprofessional nursing care services in accordance with physician orders. In addition, this role focuses on performing the following Clinical Nurse duties: Assesses, plans, implements, and evaluates the care needs of a designated group of patients or provides nursing care and identified clinical support tasks within the scope of practice for achievement of the patient's plan of care as directed. Provides professional nursing care to patients. Requires a nursing license. A professional individual contributor role that may direct the work of other lower level professionals or manage processes and programs. The majority of time is spent overseeing the design, implementation or delivery of processes, programs and policies using specialized knowledge and skills typically acquired through advanced education. A senior level role that requires advanced knowledge of job area typically obtained through advanced education and work experience. Typically responsible for: managing projects / processes, working independently with limited supervision, coaching and reviewing the work of lower level professionals, resolving difficult and sometimes complex problems.

The professional registered nurse possesses and applies the skills and knowledge necessary for the delivery and management of patient care from admission through discharge. The professional registered nurse is knowledgeable of current trends in healthcare including but not limited to advances in technology, pharmacology, treatment care modalities, quality and patient safety. The professional registered nurse serves as a patient and family advocate while facilitating a cooperative and collaborative environment among all health care providers. The professional registered nurse is responsible for the planning, delivery and management of patient/family centered care utilizing the nursing process and adhering to the standards of nursing practice embedded in research, evidence based practice and/or best practices. The professional registered nurse at Tufts Medical Center provides clinical excellence, which fosters and supports an environment central to our patient and family centered model of care.

Minimum Qualifications:

1. Registered Nurse (RN) license.

2. Basic Life Support (BLS) certification.

3. Certifications (i.e. ACLS, PALS) relevant to the department and type of care being provided may be required.

Preferred Qualifications:

1. Bachelor of Science in Nursing (BSN)

2. Specialty Nursing certifications.

Duties and Responsibilities: The duties and responsibilities listed below are intended to describe the general nature of work and are not intended to be an all-inclusive list. Other duties and responsibilities may be assigned.

1. Utilizes theoretical and evidence-based knowledge in partnering with patients and their families to assess, plan, implement and evaluate age appropriate care.

2. Assesses and collaborates with patient, family/significant others and other disciplines to: Identify expected outcomes based on synthesis of data and diagnosis; and identify cultural needs (i.e. language, etc) to develop a care plan that enhances the health care experience.

3. Plans and develops: Individualized outcomes-based care plans incorporating the patient and family's readiness and barrier to learning; Orchestrates and validates a plan of care for each shift; Initiates interdisciplinary patient/family meetings to facilitate communication regarding the plan of care; Communicates and coordinates the patients discharge plan utilizing unit-based and community resources to ensure a seamless transition for the patient and their family; Ensures the plan of care utilizes principles and concepts of project, organizational or systems management.

4. Implements: The plan in a safe and timely manner; Documents the implementation and any modifications, including changes or omissions, of the identified plan; Collaborates with nursing colleagues and others to implement the plan; Utilizes evidence-based interventions and treatments specific to the diagnosis or problem; Provides and coordinates health teaching which is required by individuals, families and groups to maintain an optimal level of health; Documents per hospital and regulatory requirements/policies, all aspects of care, including but not limited to, treatments/procedures performed and patient response.

5. Evaluates: The effectiveness of the planned strategies in relation to patient responses and the attainment of expected outcomes and knowledge; Uses the evaluation process to update the plan of care as dictated by the patient response and/or if desired outcomes have not been achieved.

6. Demonstrates and applies the skill and judgement necessary to implement the nursing plan of care, nursing interventions and procedures necessary for the care of the patient and family based upon critical thinking skills and a spirit of inquiry. The plan of care is: Evidence based and utilizes research when appropriate; Incorporates new knowledge and strategies to initiate change in nursing care practices; Demonstrates the knowledge and skills necessary to provide age appropriate culturally and ethnically sensitive care to all patients and families.

7. Performs procedures and treatments using nursing knowledge and judgment, according to established unit/practice area guidelines and professional standards.

8. Safely administers and assesses the patient response to medication utilizing essential knowledge of pharmacology and Hospital and Department Standards of Care.

9. Maintains clinical competency with respect to technology and utilizes equipment in a safe manner.

10. Performs as an advocate and as an educator for patients and families.

11. Provides high quality in an efficient and a safe manner. The professional nurse utilizes data trends to support and improve clinical practice.

12. Participates in hospital and/or unit based patient safety and quality activities and uses principles to support and improve patient outcomes (unit-based, hospital-wide, The Joint Commission, NPSGs, NDNQI, Patient First and other local, state and federal patient safety initiatives.

13. Participates in performance improvement activities through data collection, analysis and evaluation. 14. Champions quality, safety, regulatory, and patient-family satisfaction.

15. Facilitates cooperative and collaborative relationships among the various disciplines and departments to ensure effective quality patient care delivery and to create a positive and professional work environment. Supports collaboration with nursing colleagues and other disciplines to implement plan of care by participation in nursing, physician, and case management reporting rounds.

16. Delegates responsibilities to others with an understanding of their roles, knowledge and capabilities

17. Influences others to achieve Service Excellence by: Establishing a climate for optimal patient care, mutually supportive collegial relationships, and professional development; Treating both internal and external customers with courtesy, respect and caring behavior; Promoting a safe, clean, therapeutic environment for patients, families and staff; Acknowledging cultural differences that exist among staff and patients; Identifying customer service needs on the unit; Presenting self in a professional and calm manner; Providing responsible and efficient use of resources.

18. Participates in professional development and lifelong learning activities that assist in developing and maintaining their continuing competence, enhance their professional practice and support achievement of their career goals including: Maintaining current licensure and adheres to the Massachusetts Nurse Practice Act; Assuming responsibility for participating in educational opportunities to support and meet clinical competency requirements; Seeking out educational and professional resources; Developing professionally as a self-directed, motivated learner; Seeking out advanced certification opportunities and ongoing education opportunities; Precepting and mentoring newly hired staff and nursing students; Investigating available technology and resources to apply evidence based practice and research into daily professional activities; Promoting leadership at the bedside as a delegator, collaborator, facilitator, and communicator; and Promoting unit and organizational growth through a shared governance model.

19. May assume charge nurse functions in collaboration with unit leadership;

20. Facilitates communication by: Seeking and sharing job-related information that supports a culture of respect and responsibility; Assuming responsibility and ownership for professional conduct; Accepting responsibility for positive and productive communication skills; Attending and actively participating in staff meetings (when unable to attend, accepts responsibility for reading staff meeting minutes); and Accepting responsibility for reading emails to keep current with unit and hospital based information.

Physical Requirements:

1. Prolonged, extensive, or considerable standing/walking.

2. Lifts, positions, pushes and/or transfer patients and equipment.

3. Considerable reaching, stooping, bending, kneeling, crouching.

4. Frequent exposure to hazardous chemicals, sick patients, bodily substances, noise and possible exposure to radiation, lasers, electric shock, etc.

5. Regularly exposed to the risk of bloodborne diseases and other transmissible infections.

6. Contact with patients under wide variety of circumstances.

7. Subject to varying and unpredictable situations.

8. Handle emergency and crisis situations.

9. Subjected to irregular hours.

10. May have contact with hazardous materials.

Skills & Abilities:

1. Possesses and applies the skills and knowledge necessary to provide care to patients throughout the life span, with consideration of aging processes, human development stages and cultural patterns in each step of the care process.

2. Ability to provide care for a designated group of patients according to unit guidelines and hospital policies, procedures and protocols.

3. Has the skills and knowledge to provide care to the age groups of the population served including: Knowledge of growth and development; Ability to interpret age specific data and response to care; and Provide age appropriate communication.

At