Surgery

CASS REGIONAL MEDICAL CENTERHarrisonville, MO
Onsite

About The Position

Primary Purpose: To assess, plan, implement, and evaluate the care of all patients assigned to the operating room, recovery room, and outpatient surgery, as well as to manage the supplies and equipment in the OR/RR/ASU, and to provide pre and post-op education. Formal Policy-Setting Responsibilities: Formally responsible for providing input into policies associated with the job’s purpose and essential responsibilities. Routine Decision Making: If pre-op lab and results are sufficient; surgical case schedule; if patient meets criteria for discharge from PACU/ASU. Formal Supervisory Responsibility: No formal supervisory responsibility. Required Knowledge: A&P; disease process; sterile technique; standards set by Association of Operating Room Nurses Association (AORN); functions and mechanism of multiple operating room equipment. Required Skills and Ability: Computer skills; good communication skills; good organizational skills. Unusual Working Conditions: Risk of blood, body fluid contamination. Age Specific Competencies: Provides care for birth to pediatric (birth-2 yrs.), pediatric/child patients between (2 yrs-12 yrs); adolescent patients between 12 to 18 years of age; adult patients between 18 to 64 years; and geriatric patients 65 years and older.

Requirements

  • Two to four-year RN degree
  • Currently licensed in the state of Missouri
  • ACLS/BLS required
  • PALS preferred
  • Computer skills
  • Good communication skills
  • Good organizational skills
  • A&P knowledge
  • Disease process knowledge
  • Sterile technique knowledge
  • Standards set by Association of Operating Room Nurses Association (AORN)
  • Knowledge of functions and mechanism of multiple operating room equipment

Nice To Haves

  • PALS preferred

Responsibilities

  • Performs pre-procedure interviews per paper/computer correctly on all patients, evaluates the information obtained, and formulates a plan of care prior to the patient procedure.
  • Identifies the patients using two patient identifiers prior to the procedure 100% of the time.
  • Performs a comprehensive nursing assessment on patients and documents completely including appropriate signatures, times and dates. Revises plan of care as indicated from the assessment.
  • Interprets physiological information from technical equipment, on each patient and applies this information to the plan of care.
  • Documents the findings from all assessments, evaluations and implementations on the patient record where, when, and how daily.
  • Reports all critical abnormal assessments and lab values to the physician, per hospital policy and implements further orders immediately and documents details on the patient record.
  • Adequately assess and reassess pain. Utilizes appropriate pain management techniques. Educates the patient and family regarding pain management.
  • Utilizes AIDET (acknowledge, introduce, duration, explain and thank) initiatives to include managing up with each patient.
  • Utilizes only approved abbreviations in patient documentation.
  • Provides pre-operative and post-operative teaching to all patients.
  • Evaluates patient learning ability and motivational levels. Implements alternative learning measures, as evidenced by patient or caregiver verbalization or return demonstrations, as documented on the patient record i.e.; effectively communicates.
  • Effectively communicates discharge instructions to patient and responsible party at the time of discharge, per departmental discharge policy.
  • Explains all procedures and medications to patients prior to implementation.
  • Removes malfunctioning equipment from unit immediately upon discovering problem.
  • Complete requisition for repair or malfunctioning equipment by the end of shift.
  • Cleans and stocks supplies within the department, as needed.
  • Effectively communicates the plan of care on each patient to ancillary departments, case management and pharmacy staff as indicated by the orders received, patient diagnosis or condition.
  • Ensures all required documents are on the chart prior to going into the procedure room (H&P, informed consent, test results if applicable).
  • Evaluates the effectiveness of the communication, as evidenced by the preparedness of the patient and takes appropriate actions, including notifying performing physician.
  • Demonstrates thorough knowledge of location, care and operation of all departmental equipment.
  • Accurately records, handles and labels specimens; demonstrates care of specimens.
  • Ensures alarms on any assigned area are audible to alert staff.
  • Assists with the cleaning and care of surgical instrument.
  • Assists with terminally cleaning of OR rooms and documents on cleaning schedule.
  • Positions patients on operating table to facilitate surgical approach and to ensure patient safety for each case.
  • Uses padding on any boney prominences for each patient and documents on operating room record.
  • Applies cautery pads on muscular areas close to surgical site and away from any implants on each patient and documents on record.
  • Applies safety belt to each patient having surgery and documents on record.
  • Checks code blue carts each shift and upon using the cart, ensuring it has an intact tag attached.
  • If assigned as the scrub nurse, is fully responsible for care of instruments prior to, during and after the surgical case including appropriate transporting to decontamination.
  • Follows manufactures instructions for the sterilization equipment; knows responsibilities and the necessity for biological/chemical monitoring.
  • Able to accurately see and read color changes to biological and chemical monitors.
  • Pulls supplies for next day’s cases daily from departmental supplies according to physicians’ preference cards.
  • Orders special equipment as requested by physician or on preference card to have prior to surgery start time.
  • Updates preference cards to meet physician’s preferences so surgeon does not need to ask more than once.
  • Establishes and maintains effective communication and good working relationship with co-workers for the patients benefit.
  • Utilizes initiatives; strives to maintain steady level of productivity; self-motivated; manages activity and time; does not waste.
  • Participates in planning ways to solve problems and make improvements in the department as needed.
  • Represents the organization in a positive and professional manner.
  • Other duties as directed.
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