RN Clinical (Cardiac) - Surgery - Full Time 10 Hour Rotating Shifts (Non-Exempt) (Union)

As an integral part of the interdisciplinary team, the Registered Nurse utilizes the nursing process to provide therapeutic care to patients. The Registered Nurse is accountable for the coordination of patient care and education to the patient and family in accordance with the standards, policies, and practices in a compassionate, supportive, and therapeutic environment.

Essential Duties:

• Follows policies and procedures; demonstrates ability to access online manuals.
• Transfers learned scientific knowledge into practical application in applying the Nursing Process.

Nursing Process

• ASSESSMENT
• Appropriately completes Nursing Assessment upon patient admission, at each shift and with change of condition.
• Completes patient acuity by 0200/1400 daily.
• DIAGNOSIS
• Interprets assessment information and formulates Nursing Diagnoses.
• PLAN
• Develops Plans of Care with individualized interventions.
• Documents expected/projected patient outcomes.
• Reviews/Revises/Updates Plans of Care daily based on evaluation and interpretation of patient outcomes.
• INTERVENTION
• Administers medication and IV therapy appropriately at prescribed intervals.
• Completes patient care procedures correctly per policy at prescribed intervals.
• Delegates tasks based on others' scope of practice and competency.
• Acts as patient advocate.
• Manages restraint use per policy.
• Attempts alternative non-restraint measures first.
• Assures complete MD order per policy.
• Ensures MD assessment per policy.
• Assures patient monitoring per policy.
• Ensures Restraint Audit Form is completed each shift.

Documentation

• Documentation is complete and correct on all flow sheets and chart forms:
• Admission Assessment
• Pain scale assessment and reassessment before and after intervention
• Daily flow sheet
• Restraint flow sheet
• Diabetes flow sheet
• Educational flow sheet
• Kardex
• Care Plan
• Risk Assessment & Reassessment upon Fall
• MAR
• Equipment & Supplies
• Intra and Inter Facility Transfer Forms
• Belonging Tracking Form
• Ensures orders are transcribed and signed off prior to the end of the shift.
• Completes 12h/24h chart checks

Education

• Provides patient/family education as needed
• Room/unit orientation
• Plan of Care
• Identifies knowledge deficits related to diagnoses and care
• Uses and provides MICROMEDEX information to patients and families

Transfer & Discharge

• Collaborates with Case Manager and/or physician regarding discharge planning.
• Ensures all transfer paperwork is completed.
• Ensures belongings are sent with patient.

Equipment

• Utilizes patient care equipment appropriately and safely according to manufacture guidelines
• IV pump
• Feeding pump
• PCA pump
• Epidural pump
• Sequential compression device
• Wound VAC
• Heating pad/pump

Communication

• Communicates effectively with all members of the healthcare team including patient and family:
• Shift to shift report
• Physician Rounds
• Patient/family interactions
• MDP Rounds
• Hand-Off reports
• Facility E-mail
• Student/New employee/Contract employee

Organization

• Manages time effectively.
• Able to organize and prioritize responsibilities.
• Takes meal breaks without incurring overtime.
• Completes shift on time.

Observes Regulatory Agency Requirements

• National Patient Safety Goals
• Patient identifiers
• Unapproved abbreviations
• Universal Protocol (Procedural Time Out)
• Hand-Off
• Medication Reconciliation
• Clinical Alarms
• Other
• Hazardous waste management
• Biohazard
• Medication Sharps
• HIPAA
• OSHA requirements (i.e. no food or drink in clinical areas)
• JCAHO - continuous survey readiness
• Critical Values
• Write Down
• Read Back
• Follow up
• Telephone order
• Appropriate
• Documented
• Signed, Timed and Dated
• Stamped
• Entered into unit log
• Maintains safe practice in the work environment
• Correct body mechanics
• Electrical safety
• Infection Control Procedures
• Hand Washing

Management of the Care of Medical Surgical Patients (6N)

• Demonstrates the ability to manage patients with THA.
• Demonstrates the ability to manage patients with TKA.
• Demonstrates the ability to manage patients with spinal surgery (6S).
• Demonstrates the ability to maintain isolation precautions, respiratory and nutrition care specific to cystic fibrosis patients. (6S)
• Demonstrates the ability to manage medications and maintain protective isolation precautions for patients with abdominal organ transplants (6S)
• Institutes safety precautions and skin care for patients with hepatic encephalopathy.

Management of the Care of Patients in the Intensive Care Unit/S

• Demonstrates the ability to manage complex critically ill patients.
• Neurosurgery, thoracic-forgut, gastric bypass, orthopedic.
• Liver/kidney/pancreas transplants, hepatobiliary.
• Open heart, heart and lung transplants.
• Demonstrates the ability to manage advanced therapeutic modalities.
• Hemodynamic monitoring.
• Continuous renal replacement therapy (CRRT, CVVHD).
• Ventriculostomy, intracranial pressure monitoring.
• Ventricular assist devices, balloon pumps.

Management of the Care of Patients in the Stepdown/Telemetry Units

• Demonstrates the ability to manage high acuity patients requiring specialized monitoring and care.
• Status post open heart, heart transplant, lung transplant.
• Status post liver/kidney transplants, orthopedics, hepatobiliary, general surgeries.
• Status post thoracic-forgut, gastric bypass, neurology, neurosurgery.
• Demonstrates the ability to manage advanced therapeutic modalities.
• Ventilator care.
• Arterial/CVP lines.
• Ventricular assist devices.
• Lumbar drains.

Management of the Care of Patients Undergoing Dialysis Treatment

• Initiates, performs and terminates all dialysis treatments according to policy and dialysis standards of care.
• Reviews all orders and labs prior to initiating treatments.
• Informs patient of treatment plan.
• Completes all documentation completely and according to policy on the dialysis treatment record.
• Performs all pre-treatment safety checks.
• Performs appropriate machine maintenance according to dialysis policies and procedures.
• Checks charts for dialysis orders prior to arriving on the unit with the dialysis equipment.
• Calls physicians for orders early in the shift when orders for dialysis have been placed, but no treatment orders are written.
• Completes med/surg dialysis treatments on 3S whenever there are more than 2 med/surg patients scheduled.

Management of the Care of the Psychiatric Patient

• Engages patients in therapeutic interactions
• Maintains therapeutic milieu
• Assesses and monitors for patient safety including:
• Contraband assessment upon admission, change of shift and prn.
• Initiates and participates in treatment planning.
• Monitors locked doors into and out of the unit.
• Logs in Visitors and assesses for contraband.
• Follows patients' legal status q shift and communicates with Department of Mental Health and other agencies as required.
• Administers psychotropic medications only after proper consent and documentation.
• Initiates and participates in treatment planning.
• Submit Fire Arms Reporting Form

Behavioral Restraints

• Demonstrates de-escalation techniques as an effort to prevent the need for behavioral restraint/seclusion.
• Applies behavioral restraint/seclusion when appropriate.
• Continuously monitors patients for safety (or delegates as appropriate).
• Ensures physician assessment of patient within 1 hour of application of restraint/seclusion and then at least every 8 hours.
• Obtains physician orders per policy.
• Notifies Manager of all behavioral restraint incidences.
• Contacts significant other as allowed by patient.
• Completes debriefing, with patient if appropriate, after the incident.

Quality Measures

• Accurately identifies patient that fit Core Measure criteria
• Completes Core Measure Documentation
• Identifies and participates in data collection and process improvements related to Nurse Sensitive Quality Indicators

Professional Development

• Participates in professional hospital/nursing activities
• Relief Charge Nurse
• Nursing committees/councils
• Hospital Teams
• Unit Based Projects
• Research
• Published peer review article

Bonus Points

• Preceptor (5)
• Professional Certification (5)
• More than 8 Non-mandatory CEH (3)
• USCUH Nurse Week Recognition (5)
• Monthly Hospital or Unit Spirit Award Winner (1)
• Public nursing recognition (3)

Performs other related duties as assigned.

Required Qualifications:

• Req Bachelors degree Degree in Nursing.
• Req 1 year Acute inpatient hospital experience as RN.
• Req Must have excellent communication skills, including the ability to speak, read and write English proficiently.
• Req Knowledge of medical procedures and conditions and ability to understand, follow and successfully perform duties, including whole blood collection, and apheresis procedures, in accordance with administrative and clinical policies, regulations and procedures.

Preferred Qualifications:

• Pref ICU and/or Telemetry experience.
• Pref Certified Perioperative Registered Nurse - CNOR (AORN)

Required Licenses/Certifications:

• Req Registered Nurse - RN (CA Board of Registered Nursing)
• Req Basic Life Support (BLS) Healthcare Provider from American Heart Association
• Req Fire Life Safety Training (LA City) If no card upon hire, one must be obtained within 30 days of hire and maintained by renewal before expiration date. (Required within LA