Weeks Medical Center Registered Nurse Inpatient Critical Care in Lancaster, New Hampshire
The Registered Nurse Inpatient Critical Care is a highly skilled, flexible, team-oriented registered nurse who when once fully oriented to an area will provides direct patient care in that area … any department, any shift. The primary clinical areas of work include ICU, Med Surg, and House Coordination. The Registered Nurse Inpatient Critical Care provides care in compliance with hospital policies and the standards of practice of the American Association of Critical Care Nurses (AACN). In addition, the Registered Nurse Inpatient Critical Care possesses knowledge of clinical practice 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.
Current RN license in the State of New Hampshire.
Current BLS and ACLS certifications required prior to hire (or date to take has been scheduled).
Basic EKG course (minimum 24 hours) within 1 year of hire.
Critical Care Course (including ventilator management) required within one year of hire.
Current clinical experience for one (1) year minimally with critical care experience preferred.
Excellent interpersonal communication skills and organizational skills required.
Strong team player approach and flexibility to work any department and any shift. Ability to adapt to change both planned and unexpected.
PALS required within one year of hire.
Computer skills strongly preferred.
Essential Functions of the Job
Required Registered Nurse Inpatient Critical Care skills and competencies. Has competency checklist been completed with all competencies met in ICU, Med Surg, House Coordination, and other areas as appropriate?
Demonstrates current clinical competence and excellence in clinical practice as outlined in skills competency tool. Serves as a role model for other staff and provides direct clinical and professional education to other staff, students and orientees as needed. Participates in the orientation process including Precepting when asked by department manager.
Accepts professional responsibility and accountability for the quality and level of care provided to patients. Is punctual and efficient in provision of care. Rounds hourly on patients to assess for comfort and safety. Attends team huddles consistently to promote and facilitate communication of patient safety and risk concerns.
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.
Assesses new admissions immediately upon arrival. Conducts a thorough primary and secondary survey of the patient and documents findings. 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 and utilizes this plan of care as a part of shift report and handoff communication.
Engages patients in plan of care through bedside shift report, communication of the care plan, attending IDT meetings and family conferences when scheduled.
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.
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.
Recognizes and reports changes in patient condition. Implements physician orders promptly. Signs off orders and verifies medications in the EMAR. Initiates prn orders, based upon protocols and nursing judgment.
Accurately administers medications (all routes) and IV fluids. Follows all medication and IV policies and procedures including scanning of the barcodes and obtaining a witness for barcode overrides. 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.
Accurately interprets ECG 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. Anticipates physician orders.
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.
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.
Adhere to Medication Safety policies in regards to appropriately bar-coding medications and patient ID bands. Obtaining a witness whenever a barcode override for a medication to be administered is necessary. Meeting this standard would be using barcode override 3% (or less) of the time. Exceeds = 1.9% or less Meet = 2.0% - 3.9% of barcode administration override Needs Improvement = 4% or more
Accepts and satisfactorily completes miscellaneous duties as requested by the Department Manager and/or CNO.