Registered Nurse Tier 1

Appalachian Regional Healthcare, Inc.•South Williamson, KY

About The Position

The Staff Nurse interprets the plan of medical care, assesses patients, makes clinical decisions regarding nursing care, ensures care is provided safely and competently, delivers individualized care, and evaluates care for groups of patients. The Staff Nurse may provide clinical supervision to LPNs, Nursing Aides, and Nursing Service Clerks. The role includes assessing and reassessing patients; interpreting and implementing plans of care; coordinating and evaluating nursing interventions; communicating patient information and changes in condition; planning discharge and patient education; maintaining records and supplies; and collaborating with physicians and interdisciplinary teams. The nurse also provides direction and supervision for delegated nursing tasks and validates that staff performing them are appropriately prepared and competent. The role may require critical care responsibilities and specialized procedures, including operating emergency and critical care equipment, monitoring cardiac and hemodynamic data, and performing procedures such as airway care, CPR, arterial punctures, chest-tube care, and assistance with dialysis or other procedures. Before assignment as the sole RN provider, the nurse must complete an acceptable critical care course and demonstrate required competence.

Requirements

Graduation from a state-accredited or state-approved school of nursing.
Maintain current licensure in the state of practice.
Before assignment as the sole RN provider, successfully complete a critical care course acceptable to the Director of Nursing and demonstrate mastery of required equipment, diagnostic responsibilities, and procedures.
Critical care coursework must include cardiopulmonary resuscitation and management of an obstructed airway, EKG interpretation, drug therapy including emergency intravenous drug therapy or routes normally left to the physician, hemodynamic monitoring, and critical care procedures.
Receive adequate orientation to policies, procedures, and equipment, including safety procedures, infection control practices, and performance improvement activities.

Responsibilities

Receive report from the prior shift and give report to the oncoming shift, including patient condition, diagnoses, treatments, procedures, and care-plan information.
Assess and reassess patients, document nursing interventions, and evaluate patient responses to care.
Review ancillary service reports, communicate abnormal results to physicians, and notify the supervisor and physician when services are not completed.
Interpret medical care plans, evaluate patients, and develop and implement patient plans of care.
Maintain control of medicines, equipment, and supplies for the assigned unit.
Plan for patient discharge using available resources and continuity-of-care needs.
Refer patients to chaplains, social workers, and agencies as appropriate.
Provide a safe and secure environment for patients.
Assign tasks to nursing and non-nursing personnel and continuously assess and evaluate care and patient responses.
Perform nursing treatments, procedures, and total patient care in accordance with nursing standards.
Communicate pertinent patient information to physicians and assist with treatments and procedures, or delegate assistance when necessary.
Perform specialized procedures for which appropriate training and supervised experience have been received.
Plan and provide patient and family education.
Document pertinent findings, care plans, and evaluations in the medical record.
Assist patients with activities of daily living and basic human needs.
Prepare and maintain reports, charts, records, and forms required by the hospital and regulatory agencies.
Accompany patients transferred to another medical facility when required.
Notify the supervisor, physician, and/or family or guardian when a patient's condition changes, as appropriate.
Observe and evaluate the work of LPNs, Nursing Aides, and Clerks to ensure treatments and procedures comply with care plans and hospital guidelines.
Participate in teaching activities for hospital personnel and nursing students, orientation of new employees, interdisciplinary team meetings, and requested committee meetings.
Attend in-service programs and take responsibility for professional development.
Assist in developing, reviewing, and revising nursing policies and procedures.
Respect patient dignity and confidentiality.
Operate critical care and emergency equipment, including respirators, temporary pacemakers, and defibrillators.
Set up and maintain cardiac and hemodynamic monitors, interpret results, and take indicated action.
Perform specialized procedures such as endotracheal and tracheostomy suctioning, tracheostomy care, extubation, CPR, arterial punctures, chest-tube and Pleur-evac care, and setup or assistance with peritoneal dialysis, paracentesis, and thoracentesis.
Determine which nursing tasks may be delegated and to whom; direct and assist supervised personnel; monitor their work; and evaluate task performance.
Ensure personnel performing delegated nursing acts have the necessary education and validated competence to perform them safely.
Perform other related duties within the job classification and other duties as assigned.