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CRITICAL CARE FLEX RN
Location: Weeks Medical Center
Shift: Varied shifts Full-time
Job Details: - CPR Required
- 1-2 yrs experience required
The Critical Care Flex RN is a highly skilled, flexible, team-oriented, critical care registered nurse who is fully oriented to and provides direct patient care inany critical care department, any shift. The primary clinical areas of responsibility include ICU, ED and House Coordinator. The Critical Care Flex RN (CCF-RN) frequently functions in an education role at the bedside. She/he is responsible for precepting and mentoring RN staff in the ICU or ED. The CCF-RN also coordinates clinical and/or information technology projects in the clinical departments. The CCF-RN provides care in compliance with hospital policies and the standards of practice of the American Association of Critical Care Nurses (AACN). In addition, the CCF-RN possesses knowledge of clinical practice standards from national organizations and CMS. Nursing practice is in compliance with the New Hampshire Board of Nursing rules, and the rules, regulations, policies, procedures and Standards of Nursing Practice of Weeks Medical Center.
The CCF-RN is accountable first to the Critical Care Department Manager and second to the Chief Nurse Executive.
The CCF-RN works closely with the general Medical Staff, nurses from other departments, as well as, clinical and support staff from all disciplines. The CCF-RN demonstrates excellent interpersonal skills when interacting with colleagues, physicians, patients, families and the general public. The CCF-RN is a positive and enthusiastic problem-solver.
v Current RN license in the State of New Hampshire.
v Current BLS and ACLS certifications required prior to hire. TNCC and PALS required within one year of hire.
v Basic EKG course (minimum 24 hours) required prior to hire. Chemotherapy course required within 2 yrs of hire.
v Critical Care Course (including ventilator management) required prior to hire.
v Current clinical experience for at least five (5) years required; a minimum of two of these years must be in ICU and/or ED.
v Excellent interpersonal communication skills and organizational skills required.
v Strong team player approach and flexibility to work any department and any shift.
v Computer skills strongly preferred.
1. Demonstrates current clinical competence and excellence in clinical practice as outlined in skills competency tool. Serves as a role model for other critical care staff and provides direct clinical and professional education to critical care and med/surg nurses, students and orientees.
2. Accepts professional responsibility and accountability for the quality and level of care provided to patients.
3. Accepts responsibility and accountability to identify and report Risk Management situations. Completes occurrence and analysis reports and submits them to the Risk Manager within 24 hours of the event. Notifies the Department Manager or Supervisor when risk related situations arise.
4. Ensures proper and economical use of equipment and supplies for patient care. Makes recommendations to improve the cost effective use of supplies. Makes recommendations on new products to the Value Analysis committee.
5. Ensures that proper charges are generated from each patient, including medication and supplies. Manages time effectively.
6. Completes patient care and departmental requirements within established shift and reports off duty on time.
7. Assesses new admissions immediately upon arrival. Conducts a thorough primary and secondary survey of the patient and documents findings.
8. Immediately recognizes abnormalities in airway, breathing and circulation and intervenes quickly and appropriately. Accurate and thoroughly completes the Admission Assessment for each patient. Completes a Plan of Care according to unit specific standards.
9. Reassesses each patient (frequency according to unit standards) and following treatments, medications and interventions. Reassesses all patients with abnormal vital signs. Documents findings and outcomes of interventions.
10. Prepares the initial C are Plan based upon the assessment findings. Reviews and updates the C are Plan according to unit standards. Resolves Care Plan issues prior to discharge and signs them off as resolved.
11. Plans for the admission, discharge and transfer needs of each patient. Communicates with the House Coordinator (or Manager) regarding admissions, discharges and ALL acute care transfers. Discusses discharge planning needs with Case Management as appropriate.
12. Implements physician orders promptly. Signs off orders so that the team knows the orders have been implemented. Initiates prn orders, based upon protocols and nursing judgment. Accurately completes the chart reviews for each patient.
13. Accurately administers medications (all routes) and IV fluids. Follows all medication and IV policies and procedures. Demonstrates knowledge of medication protocols (i.e. cardiac medications, post-anesthesia medications, oncology medications). Obtains a weight on each patient and accurately calculates drip rates for vasoactive medications based upon the patient’s weight. When indicated based upon unit standard practice, prints a medication chart from the monitoring system to correspond to the weight-based dosing of medications.
14. Accurately interprets EC G rhythms and responds appropriately. Interprets the rhythm strip based upon actual human analysis, not relying on the machine interpretation. Notifies the physician for significant rhythm changes and obtains orders as appropriate. Demonstrates the ability to recognize ischemia, injury and infarction on a 12 lead EKG. Demonstrates the ability to rapidly intervene when these signs are present.
15. Anticipates physician orders.
16. Assists physicians with treatments and interventions (ie central line insertion, cardioversion, etc). Anticipates needs related to the treatment or intervention and thoroughly prepares the patient and the room. Applies Holter monitors and Loop monitors as ordered. Scans Holter monitor tapes with a high degree of accuracy and interprets results. Notifies physicians of significant arrhythmias. Processes charges and reports.
17. Reports significant changes in the patient’s condition to the attending physician. Documents evaluation findings. Obtains orders to intervene as needed. Evaluates the response to therapy and interventions. Documents patient outcomes following a treatment or intervention.
18. Provides education to patients and family members related to their health condition and treatment plan. Works in collaboration with the physician to provide patient education and discharge planning.
19. Actively participates in the orientation of new personnel to the critical care departments. Orients new personnel by demonstrating processes and observing a return demonstration, to ensure that the new employee performs according to Weeks policy and standards. Collaborates with existing staff to mentor and grow their critical care knowledge and skills at the bedside.
20. Participates in policy/procedure formulation and decision-making through Nursing Department committees. In collaboration with the Department Manager assures completion of the annual policy review and development of new policies, procedures and protocols as needed.
21. Identifies CQI projects for critical care and in collaboration with the Department Manager, leads and / or facilitates the project. Leads the team in the design and implementation of new clinical practice guidelines / standards in critical care. Actively participates with the IT department in Clinical / IT projects related to critical care.
22. Accepts and satisfactorily completes miscellaneous duties as requested by the Department Manager and/or CNE.
Job Code: 61201010