Registered Nurse - Perianesthesia PACU- Full Time- 4-10's

Summary of Position: 

Responsible for the delivery of safe, effective, and quality patient-family centered care in the preoperative and postoperative units. The Perianesthesia RN is responsible for providing professional nursing care to patients in the Surgery Department, utilizing established policies and procedures, ensuring safe and effective care. This position is responsible for accurately and safely administering sedation/analgesia, monitoring patients’ responses, ensuring patient safety during procedure and documenting according to policy & procedure. Services are provided based on the ages of the population served; 1 year through geriatric - 65 years or older and in collaboration with the multidisciplinary care team. The RN demonstrates the knowledge and skills necessary to identify and meet the individualized needs of all patients served in Surgery Department.

Qualifications

Education:

● Completion of an accredited Nursing program.

● Bachelor’s degree in Nursing (BSN) preferred.

Experience:

● Candidates with previous acute care experience will be given preference.

● Previous PACU or ICU experience preferred.

Knowledge/Skills/Abilities:

● Requires critical thinking skills, decisive judgment and the ability to work with minimal supervision.

● Must be able to work in a stressful environment and take appropriate action.

● Proficient computer skills as are required to document, communicate and enter information into the electronic medical records system.

● In compliance with patient safety standards, must be able to effectively communicate in English; Bilingual abilities preferred.

Certifications/Licensure:

● Current California and Nevada RN license or ability to obtain prior to start date.

● Current CPR/BLS certification by the American Heart Association (BLS for the Healthcare Provider)  required

● ACLS certification required

● PALS certification required

● Certified Post Anesthesia Nurse (CPAN) or Certified Ambulatory Perianesthesia Nurse (CAPA) certification preferred

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 

● While performing the duties of this job, the employee is frequently required to walk, stand, sit, and talk or hear. 

● The employee is occasionally required to use hands to finger, handle, feel or operate objects, tools, or controls; and reach with hands and arms.

● The employee is occasionally required to climb or balance; stoop, kneel, crouch, or crawl.

● Specific vision abilities required by this job include close vision, color vision, and the ability to adjust focus.

● Lifts, positions, pushes and/or transfer patients.

● The employee must occasionally lift and/or move up to 50 pounds.

Working Conditions 

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

● Routine Hospital/Healthcare & Office/Administrative conditions.

● Contact with patients and guests under a wide variety of circumstances.

● Regularly exposed to the risk of bloodborne diseases.

● Exposure to infections and contagious disease.

● Exposed to hazardous anesthetic agents, body fluids and waste.

● Subject to hazards of flammable and explosive gases.

● Subject to varying and unpredictable situations, including the handling of emergency or crisis situations.

● Subject to pressure due to irregular hours, frequent interruptions and stressful situations due to multiple demands.

● Occasional travel to various health system locations. 

Essential Functions

1. Provides consistently exceptional care at all times.

2. Provides patient care, evaluates outcomes, consults with others as required and adjusts care plan as necessary to ensure optimal care.

3. Assess patients at intervals as stated in policies and procedures.

4. Based on assessment findings individualizes care plan for each assigned patients. 

5. Medication administration is followed with departmental and hospital policy.

6. Monitors patient reaction to physician orders. Reports any untoward change in patient condition to appropriate individual(s). Correctly and concisely reports patient status.

7. Recognizes unusual conditions outside of his/her expertise and seeks guidance of coworkers or supervisor. 

8. For urgent add-ons, functions as a preadmit nurse

a. Performs nursing history and physical 

b. Provides patient pre-procedure education (i.e. NPO status, medication instructions, etc.)

c. Obtains preoperative testing results

d. If necessary, sends chart to anesthesia for review

9. Functions as a preoperative nurse

a. Performs initial patient assessment

b. Provides patient and procedure specific education

c. Prepares patient for procedure (obtains vitals, starts IV, etc.)

10. Functions as a postoperative nurse.

a. Performs initial patient assessment

b. Apply the relevant scoring system/discharge criteria for patient transfer (e.g., Aldrete Score, Modified Aldrete Score [i.e., PARSAP], Post Anesthesia Discharge Scoring System [PADSS], White) score accurately as defined by organizational policy.

c. Provides acute pain and comfort management as needed

d. performing interventions to maintain the integrity of the patient’s wound and tissue perfusion at or above baseline levels;

e. performing interventions to maintain the status of the patient’s genitourinary, gastrointestinal, musculoskeletal, endocrine, respiratory, cardiovascular, and neurological systems, and fluid, electrolyte, and acid-base balances at or above baseline levels;

f. Performs interventions to ensure the patient is at or returned to normothermia at the conclusion of the immediate postoperative period;

11. Accurately and safely administers sedation/analgesia.  Monitors patient response, ensures patient safety during procedure and documents according to policy & procedure. Utilizes moderate sedation (following appropriate policy/procedure) while assisting with regional anesthesia placement or local with MAC. 

12. Assists physicians with examinations, procedures, including sedation, and other processes related to direct patient care. Assists Anesthesiology with regional anesthesia. 

13. Accurately and safely discharges patients utilizing the discharge criteria.

14. Keeps patient/family informed of progress, procedures, and disposition. Focuses on customer service needs. 

15. The patients learning needs, abilities, preferences and readiness to learn is assessed.   

16. Monitors and ensures accuracy of documentation in patient medical record. 

a. Ensure completeness of chart and electronic medical record to include surgical navigators.

17. Operates equipment and performs job related duties in a safe manner. Insures proper functioning of equipment and follows procedure when equipment malfunctions. 

18. Orients, instructs and trains assigned personnel.

19. The staff member is able to demonstrate knowledge and skills necessary to provide care appropriate to the age of the patients served. The individual demonstrates knowledge of the principles of growth and development over the lifespan and possesses the ability to identify each patient’s age-specific needs. 

20. Transfer care as applicable.

21. Demonstrates a working knowledge of regulatory and licensing standards and ensures that practice is compliant with standards (AORN, ASPAN, CDC, OSHA, Joint Commission, CDPH, Title XXII, and CMS). 

22. Performs monthly outdates on medications and supplies.

23. Assists with ordering of supplies (to include medications and nutrition stock).

24. Environmental services duties to include cleaning of the preoperative and postoperative areas.

25. Delegate tasks according to the state Nurse Practice Act and job descriptions.

26. Document nursing care accurately, completely, and legibly.

27. Collaborate effectively with other disciplines as applicable.

28. Participate in quality review and performance improvement projects.

29. Participate in the performance appraisal process.

30. Use problem-solving and conflict resolution skills to foster effective work relationships with team members.

31. Maintain required competencies.

32. Responds to the needs of the department by performing other duties, as necessary.