|Nurse - RN - Emergency Room Nights|
FT- 7 PM Ė 7 AM
POSITION SUMMARY: Responsible for nursing care, to include assessment, medications, education and patient safety in an optimal, cost effective manner. Performs duties under the supervision of the Unit Manager/Nursing Coordinator. Works cooperatively with all nursing personnel, ancillary staff and supportive services. Receives orders from the physician as to medications, treatment and discharge instructions. Responsible for individual schedule changes, ordering of supplies/medications, knowledge of location and the use of emergency equipment, filling out 24 Hour Report, distribution of paperwork and accuracy of the narcotic count/administration of medications. Work is subject to periodic evaluation for compliance with policies and instructions and for meeting professional standards of emergency nursing care. Expected to participate in Quality Improvement. Maintains patient/staff confidentiality. Able to read cardiac monitor. Knowledge of computer documentation.
- Graduate of an accredited School of Nursing
- Prefer at least 1 to 3 years progressive nursing experience as a floor nurse in medical/surgical, pediatrics, obstetrics, or ICU
- If no prior ER experience, must possess the ability and desire to learn
Minimum Field of Expertise:
- Ability to plan and organize care of emergent, urgent and non-emergent patients
- Participation in continuing education
- Knowledge of new trends and techniques in Emergency Nursing
- Demonstrates annual competency of selected clinical skills
- CEUs to maintain RN license
- Current Kansas license with biennial renewal
- BLS affirmation
- Moderate to heavy physical efforts
- Frequent, standing, walking, sitting, stooping, bending, reaching
- Frequent lifting patient, supplies, equipment
- Manual dexterity and mobility
- Must be able to lift arms above head
- Rapid and efficient response to emergencies
- Must pass the Physical Capacity Profile Testing (3)
Required protective equipment:
- Precautions/Isolation according to policies/procedures for: a. exposure to blood, body fluids, infectious materials; b. exposure to chemical hazards, slippery surfaces; c. exposure to noise and noxious odors; d. electrical equipment.
- Ability to see clearly at 20 feet or more
- Ability to see clearly at 20 inches or less
- Ability to see peripherally
- Works effectively with others, possessing tact, discretion and diplomacy
- Demonstrates leadership and teaching skill
- Possesses the ability to work under pressure
- Maintains good physical and emotional well being
- Effective communication skills
- Ability to work quietly and as a part of the team
- Attends staff meetings
- Appropriate, clean attire according to department of nursing dress code, wears nametag and identifies self to patient.
- Possesses integrity
- Takes initiative
- Role model
- Maintains a positive attitude
- Able to prioritize tasks and complete patient care within a timely manner and shift hours.
- Is subject to stressful conditions
- Assigned to a home unit and shift or shifts.
- Can expect to be reassigned to another shift as necessary for staffing.
- Requires weekend and holiday work.
- Is subject to overtime due to fluctuation in workload.
- May be required to provide patient care in an ambulance transfer
- Is subject to call back for mass casualty situations
Degree of Supervision Required:
- Must be able to work independently
DUTIES OF AN EMERGENCY DEPARTMENT REGISTERED NURSE
- Performs nursing care to patients in a positive manner reflective of the hospitalís philosophy and objectives.
- Plans safe, efficient and economical nursing care of patients while at the same time meeting JCAHO and other relevant standards.
- Maintains knowledge of All Hospital Plans; Department of Nursing/Unit Policies & Procedures; Infection Control Manual and the Personnel Policy Handbook. Work performance is consistent with these policies and procedures.
- Maintains positive physician - nurse rapport.
- Dates/times and implements physician's orders.
- Performs triage assessment with a systematic collection of data related to chief complaint on all patients presenting to the emergency department.
- Assesses nursing care needs by triaging of patients as emergent, urgent, or non-emergent related to chief complaint of subjective and objective data.
- Monitors patient condition and maintains accurate documentation. Reports abnormalities or instabilities of patientís condition in a timely manner to appropriate individuals (physician, mid-level practitioner, peers, Unit Manager and nurse coordinator).
- Accurately enters orders and related information in the computer. When the computer is ďdownĒ the paperwork is to be completed manually.
- Initiates/completes surgical/procedural permits and pre-op check lists.
- Reduces patientís and significant otherís anxiety through education and emotional support. Provides patients and significant others with an explanation of condition/procedures. Assesses impairment(s) affecting patientís/significant otherís ability/willingness to learn.
- Reviews home care/discharge instructions with patient and/or responsible party (i.e. Nursing Home staff), as evidenced by documentation.
- Performs appropriate medication administration utilizing the five rights and two forms of patient identification. Assumes responsibility for routine, PRN, and stat medications.
- Demonstrates knowledge of IV therapies. Stays current with knowledge of pump functions.
- Demonstrates understanding and correct charging for various procedures, physician, and ER.
- Assumes responsibility for checking outdated medication(s).
- Assumes responsibility for checking the crash cart.
- Counts narcotics at end of shift. Informs unit manager/nursing coordinator immediately when the count is not accurate. All staff must remain in the unit until this situation is rectified.
- Adequate vigilance over patients, insuring necessary safety precautions: (rails up, bell within reach when not in line of sight) frequent visual observation, restraints and attention to needs.
- Provides a calm, quiet atmosphere.
- Recognizes legal responsibilities and functions within limitations as specified by law.
- Assists other staff members as needed.
- Attends 100% of all staff meetings/mandatory classes unless excused by the Unit Manager.
- Participates in assigned committees.
- Maintains positive working relationship with all personnel in a professional manner.
- Ensures working area is clean.
- Determines and documents chief complaint with signs and symptoms, brief history, and baseline vital signs.
- Submits lists of suggested equipment needs to Unit Manager for consideration in budget.
- Reports on patients remaining to oncoming shift with concise, pertinent information.
- Informs Unit Manager of any immediate supply and/or equipment needs not able to be met through regular procedure.
- Keeps Unit Manager, Nurse Coordinator and/or Chief Nursing Officer informed as to staffing needs, number of patients and or acuity in the emergency department.
- Identify/document comfort measures, pain control and reaction to those measurers.
- Notify discharged patients of abnormal lab findings.
- Document all cultures in the logbook.
- Participates in the orientation of new personnel.
- Participates in policy and procedure formulation and/or revision.
- Verbalizes problems and/or dissatisfaction and explores solutions, fill out Variance Reports as appropriate.
- Demonstrates familiarity with use of specialized equipment in the ER such as heart monitors, defibrillator, blanket warmer, EMS communications, etc.
- Provides care that demonstrates ethical beliefs and respect for patientsí rights by obtaining authorization for treatment, following regard to treatment of minors, patients with STD, and the unconscious incompetent patient.
- Shall demonstrate an awareness of current state and local laws governing the delivery of care to the emergency patient by following forensic specimen collection, reporting cases to the authorities, COBRA laws, OSHA regulations.
- Follows Standards of Care for Emergency Nursing.
- Reads and initials information regarding memos, new Policies and Procedures, schedule changes, L. A. Express and Staff News.
- Responsible for safe operation of equipment.
- Participates in and/or initiates codes when necessary. Follows Code Blue, ACLS algorithms and proper defibrillation techniques.
- Has taken a dysrhythmia course or demonstrates knowledge of dysrhythmias through proper identification of rhythm strip.
- Takes proper action for specific cardiac arrhythmias documented
- Follows procedure for notification of coroner, rape support team, minister, and police vs. sheriff.
- Functions with speed and accuracy in emergency situations.