Within the RN scope of practice as defined by the Oregon State Board of Nursing, applies the nursing process to the care of patients. Teachespatients and significant others. Documents patient care in the medical record. Collaborates with the interdisciplinary team to effectivelycoordinate overall care of the patient.
PRINCIPLE DUTIES AND RESPONSIBILITIES
• Assesses patients, as appropriate to the scope of care the nurse will provide. Assessments may include: physical, psychosocial, learningneeds and barriers, needs related to age/culture, discharge planning.• Establishes nursing diagnoses based on results of assessments and in collaboration with the interdisciplinary team.• Plans care according to identified diagnoses and needs. Updates plan of care as appropriate.• Implements/performs individualized care, based on nursing care plan and the nurse’s role with the patient. This care may include but notbe limited to:• Assisting with activities of daily living, including fall risk management and safe patient handling.• Medication administration• Skin assessment/wound care• Pain management• Operation/manipulation of biomedical and other patient care and testing equipment, including but not limited to infusion pumps, patienttransfer equipment, cardiopulmonary monitors, invasive catheters and drains, thermoregulation devices, measurement devices,medication dispensing cabinets, external therapeutic devices.• Assisting the physician and other licensed, independent practitioners with invasive and non-invasive procedures.• Teaching patients and their families about current illness, medical tests, medication, general healthcare, illness and disease prevention,and wellness promotion.• Providing appropriate assignment, supervision, and direction to unlicensed assistive personnel in order to ensure optimum patient care.• Providing interdisciplinary coordination and facilitation of overall care.• Documents patient assessments, interventions, care, and teaching in the electronic medical record. Documents in paper format, asnecessary. Documentation is complete, concise, timely, and legible.• Evaluates care provided, communicates patient status and results of care to the interdisciplinary team.• Other duties as assigned
SKILLS AND ABILITIES
• Creates safe therapeutic milieu on the unit• Attends group activities, observes patient interaction; participates as requested by group leader• Participates in treatment team meetings• If appropriately credentialed, performs duties of Qualified Mental Health Professional as assigned• Able to read, write legibly, and converse effectively in the English language.• Exhibits critical thinking and problem-solving skills• Flexible, able to prioritize and adapt to rapidly-changing patient and unit needs.• Demonstrates effective teaching skills.• Responds effectively to patient crisis/emergency situations• Proficient in use of computer, including accessing internet, word processing, and documenting in an electronic medical record system.• Maintains regular, consistent and punctual attendance at the assigned job location