Progressive Care / Step Down
Registered Nurse
MAIN FUNCTION:
Assesses, plans, implements, evaluates and documents
the care of medical and surgical adolescent/adult patients with a cardiac
focus. Assists with special procedures. Directs the care delivered by others in
the department. Designated stroke unit. Accepts med surg overflow patients as
necessary. Recovers cardiac cath/special procedure patients. Provides care for
patients on intravenous vasoactive medications (step down patients).
MUST HAVE REQUIREMENTS:
- Cross train and maintain competency to Step-down Nursing within 1 year
- ACLS within 1 year of hire, and maintain while in position
- Complete NIH stroke certification within 6 months and maintain while in position
PREFERRED ATTRIBUTES:
Ability to read and operate cardiac monitor, recognize
normal/abnormal rhythms, and institute appropriate interventions.
Other Position Expectations
Demonstrates ability to care for step-down patients,
including vasoactive medications, within 1 year of completion of orientation.
OTHER REQUIREMENTS:
Employees in this position may be:
- Exposed to blood, body fluids and/or airborne pathogens and are required to wear personal protective equipment
- Employees in this position must be able to push, pull, lift, carry, turn, crouch, and bend as necessary to complete nursing care tasks
- Required to take "on call" status
- Reassigned to another nursing unit to provide nursing care within current job description
- Subject to STHR (short term hour reduction) according to policy
POSITION EXPECTATIONS: All expectations detailed below are considered ADA
(American Disabilities Act) Essential.
Leadership
- Demonstrate ability to lead/direct a team of caregivers in providing care for a group of patients.
- Facilitates teamwork by adhering to Nursing Practice Model.
- Accepts and responds to change productively, while maintaining a positive attitude
- Role models professional nursing practice and behavior
- Demonstrates conflict resolution skills
- Effectively implements the nursing process for assigned group of patients including appropriate delegation
- When/if assigned as Relief Charge Nurse, functions in a professional and thoughtful manner, demonstrating:
- Decision-making and priority setting skills
- Time management and effective use of resources
- Appropriate delegation skills
- Conflict resolution skills
- Adherence to Relief Charge RN unit responsibility list
- Professional communication that fosters a calm and orderly environment
Communication
- Maintains awareness of verbal / non-verbal communication in interactions with staff, other departments, physicians, patients and families
- Maintains patient confidentiality in all communication interactions: written, verbal, electronic, and digital
- Collaborates and communicates effectively with all members of the health care team
- Reports critical information to physician and others as indicated
- Properly utilizes chain of command to handle issues
- Facilitates communication between staff members, i.e. conducts shift huddles
- Demonstrates basic ability to initiate and manage crucial conversations
- Utilizes AIDET (Acknowledge, Introduce, Duration, Expectations, Thank You) strategies to foster positive communication
- Interacts with clinical students in positive, productive manner
- Communicates all pertinent information regarding patient and their care needs to nursing and other departmental staff as reasonable and necessary (ex. handoff communication, hall pass, report)
Operations
- Maintains appropriate clinical skills:
- Administers care according to WCH/unit policy/procedure, current standards of care and Ohio Nurse Practice Act
- Performs assessments/reassessments and documentation relevant to patient's condition, needs and age, per nursing documentation guidelines. Communicates changes in patient condition to physician in timely manner and suggests possible interventions and course of care as appropriate in a collaborative manner.
- Initiates, evaluates and reviews plan of care
- Provides age appropriate health teaching related to diagnosis, identified patient/family needs and medication, using available teaching resources and assuring patient family understanding by teach back
- Administers medication safely:
- Correctly demonstrates use of CPOE(Computer Physician Order Entry)
- Demonstrates knowledge of drug purpose and effectiveness as related to diagnosis
- Follows 6 rights of medication administration
- Demonstrates appropriate/safe medication handling/administration
- Reassesses and documents effectiveness of medication
- Assures team members huddle and round on patients to :
- Evaluate the environment to assure safety & infection control standards are met
- Evaluate the care provided to assure it is based on practice standards and evidence based practice
- Evaluate the educational plan and its implementation; assessing for and addressing gaps in care
- Evaluate for any additional /alternative care needs, and patient/family satisfaction
- Evaluate adherence to nursing practice standards of care and documentation of care by the nurse and team members
- Coordinate work to achieve maximum productivity. Able to multitask and prioritize workload. Work habits are consistently adjusted to accommodate multiple responsibilities and are prioritized and completed in a timely manner.
- Demonstrate reasonable and rational judgment in decision making
- Other duties as assigned by management team
Customer Service
- Displays positive attitude. Treats others with honesty and respect. Speaks positively in all customer interactions internal and external.
- Assess customer satisfaction when rounding on patients and use appropriate chain of command for unresolved issues or problems.
- Use AIDET (Acknowledge, Introduce, Duration, Explanation, Thank you) to:
- Optimize the patient’s experience by reducing the patient and family’s anxiety and increasing the patient’s compliance
- Develop positive relationships with other departments to foster patient satisfaction
- Use face to face resolutions (crucial conversations) to intervene with patients or staff in situations where customer needs have not been met to determine a positive, mutually agreeable resolution
Staff Development / Personal Growth
In conjunction with the Department Director, Clinical
Specialist and / or Educator:
- Function as a preceptor, seeking learning opportunities for orientee/student. Interact with department manager, clinical educator/instructor, to evaluate orientee/student progress toward goals, identifying additional needs.
- Demonstrates initiative and responsibility to develop personal, leadership and professional goals
- Demonstrate professional development by attending conferences, participating in committees/unit projects and ongoing educational activities
- Demonstrate professional growth by maintaining awareness of changes in nursing practice/evidenced based nursing care
- Accept feedback as opportunity for growth
- Demonstrates knowledge and understanding of new policies and procedures, practices, changes in practice, and initiatives. Obtains this knowledge via staff meeting attendance, reading of communication, required hospital education, discussion with departmental leadership and peers.
Performance Improvement
- Identify processes to be improved and communicate to management team. Assists in data collection as directed
- Participates on at least one team, project and/or committee: unit, departmental or hospital based
- Develop and maintain awareness of DNV, CMS (Centers for Medicare Services) and other required quality and safety measures
- Develop and maintain ongoing understanding of Nursing best practices for the types of patients for whom care is provided.
Full time RN position on the Progressive Care unit working 7am-7pm, three 12 hour shifts per week and every third weekend rotation with a holiday requirement.
